Background. Females presented with hydrosalpinx have lower rates of pregnancy by artificial reproductive techniques. There are variable management strategies for hydrosalpinx as: salpingostomy, salpingectomy, proximal tubal ligation and trans-vaginal aspiration; but recent management techniques which proved effective in improving outcome of intracytoplasmic sperm injection (ICSI) are laparoscopic tubal ligation and salpingectomy. Aim of the present study was to compare the ovarian reserve and ICSI outcomes after performing either laparoscopic tubal separation or laparoscopic salpingectomy in females with hydrosalpinx. Patients and methods. The study was performed in Department of Gynecology and Obstetrics, School of Medicine, Zagazig University in about 3 years. Patients who fulfilled the inclusion criteria were divided into two groups. Group A included 60 patients that underwent bilateral Laparoscopic proximal tubal separation and group B included 60 patients that underwent bilateral laparoscopic salpingectomy before ICSI. The outcome evaluated parameters of the study were; rates of clinical pregnancy and live births in addition to changes in parameters of ovarian reserve, changes of rate of fertilzation, rate of cleavage, rates of implantation and rates of miscarriage. Results. In the salpingectomy group after surgery we found a significant increase in the serum FSH and serum estradiol levels, a significant reduction in the post-surgery AFC and a significant reduction of levels of serum AMH than the other group (p < 0.001). We showed that patients who underwent salpingectomy needed more stimulation days, lower rates of fertilization and higher doses of gonadotr tients with bilateral tubal separation (p < 0.001). Conclusions. Our study demonstrated the benefits of laparoscopically tubal separation over salpingectomy in patients with hydrosalpinx regarding preventing reduction in ovarian reserve particularly in women underwent ICSI. SUMMARY Context. Women presented with idrosalpinge show lower pregnancy rates by artificial reproductive techniques. There are variable management strategies for hydrosalpinge such as: salpingostomy, salpingectomy, ligation of the proximal tubes and transvaginal aspiration; but recent management techniques that have proven effective in improving the outcome of intracytoplasmic sperm injection (ICSI) are laparoscopic tubal ligation and salpingectomy. The aim of the present study was to compare ovarian reserve and ICSI outcomes after performing laparoscopic tubal separation or laparoscopic salpingectomy in women with hydrosalpinge. Patients and methods. The study was conducted at the Department of Gynecology and Obstetrics, Faculty of Medicine, University of Zagazig in about 3 years. Patients who met the inclusion criteria were divided into two groups. Group A included 60 patients undergoing bilateral laparoscopic proximal tubal separation, and group B included 60 patients who underwent bilateral laparoscopic salpingectomy prior to ICSI. The parameters evaluated for the outcome of the study were: clinical pregnancy rates and live births as well as changes in ovarian reserve parameters, changes in fertilization rate, splitting rate, implantation rates and miscarriage rates. Results. In the salpingectomy group after surgery we found a significant increase in serum FSH and estradiol levels, a significant reduction in post-operative AFC and a significant reduction in serum AMH levels compared to the other group (p < 0.001). We showed that patients undergoing salpingectomy needed more days of stimulation, lower fertilization rates and higher doses of gonadotropins than patients with bilateral tubal separation (p < 0.001). Conclusions. Our study demonstrated the benefits of laparoscopic tubal separation compared to salpingectomy in patients with hydrosalpinge with regard to the prevention of reduction of ovarian reserve, particularly in women undergoing ICSI.