Evaluation of Vaginoscopic versus Traditional Office Hysteroscopy in Nulliparous Infertile Patients (prospective Cohort study) ABSTRACT: Background: Diagnostic hysteroscopy is a minimally invasive technique that provides immediate direct vision of the uterine cavity. Therefore, in order to improve the acceptability and comfort level of office hysteroscopy and to increase the success of the outcome, we compared the vaginoscopic and standard hysteroscopy methods in this study. Zagazig University has never conducted research in this area before. Methods: This prospective cohort study was conducted at Gynecology Outpatients, Obstetrics and Gynecology Department at Zagazig University Maternity Hospital. The study included 108 patients divided into 2 groups, vaginoscopic and traditional hysteroscopic groups, and then the outcomes were compared between the 2 studied groups. Results: Those who underwent Traditional hysteroscopy had more pain, higher procedural time median values than vaginoscopic hysteroscopy. Conclusion: Compared to the standard hysteroscopy using the speculum, the vaginoscopic approach is more successful as it is quicker, less painful and better tolerated. It should be preferred in an outpatient setting.