Pelvic inflammatory disease ( Pill) is a major public health problem.PID remains the most common serious complication of the epidemic ofsexually transmitted diseases among women.It is nearly always bilateral and is essentially a disease of youngadults occurs after labor, abortion, or operation, or after IUD insertion.It is a poly microbial pelvic infection, with Chlamydia trachomatis,Neisseria gonorrhoeae, Aerobic and Anaerobic bacteria being the mostcommon isolates.The most significant impact of PIn is its long-term adverse effectson the reproductive health of young women. These sequelae include: tubalfactor infertility, ectopic pregnancy, chronic pelvic pain, pelvic adhesivedisease, and tube-ovarian abscess (TOA).The clinical criteria of PIn are insensitive and non specific, andfalse-positive and false-negative diagnosis is common.Laparoscopic studies of women with a clinical diagnosis of acutepelvic inflammatory disease have established the inadequacy of diagnosisby the usual criteria of history and physical and laboratory examination.Laparoscopy should be recommended with the following advantages:Confirm the diagnosis, in cases with proven Pill ( true-positive)additional operative procedures can be performed, such as liberation ofadhesions, peritoneal lavage, drainage and lavage of the abscess. Theseprocedures seem to shorten the need for hospitalization and may improvefertility outcome. On the other hand, in non PID cases ( false-positive),operative laparoscopy greatly facilitate diagnosis and treatment of othergynecologic or non gynecologic conditions.