Abstract Objectives: The current study aimed to evaluate accurate diagnosis of tubal patency by hysteroscopic air bubble technique compared with hysterosalpingography. Patients and Methods: This cross-sectional study was conducted on 42 cases in endoscopy unit in Obstetrics and Gynecology Department of Zagazig University hospitals.All included participants in the study will be subjected to:Medical and obstetric history, some routine fertility investigations as; semen analysis, hormonal profile, folliculmetry. Hysterosalpingography then patients with abnormal results for tubal patency by HSG underwent diagnostic hysteroscopy using air bubble technique then laparoscopy for diagnosis of tubal patency. Results:There was a highly statistically significant difference in the findings of hysterosalpingography technique versus laparoscopy in the detection of right tubal patency (p <0.001). The hysterosalpingography technique showed 52.2% sensitivity, 100% specificity, 73.8% accuracy, 100% PPV and 63.3% NPV. The hysteroscopic air bubble technique revealed higher sensitivity, accuracy and NPV as compared with hysterosalpingography technique in detection of overall (right and left) tubal patency. However, the hysterosalpingography technique revealed higher specificity and PPV. Conclusion:Our study showed good sensitivity and specificity of both HSG and Hydroscope with no significant difference in results but Hysteroscope may be more accurate.The hysteroscopic air bubble technique revealed higher sensitivity, accuracy and NPV as compared with hysterosalpingography technique in detection of overall (Right and left) tubal patency. However, the hysterosalpingography technique revealed higher specificity and PPV. Keywords:Hysterosalpingography, Hysteroscopic Air Bubble, Laparoscopy, tubal patency.