One hundred sixty-one women undergoing laparoscopy for infertility of obstructive origin (fallopian tube stenosis or obstruction and periadnexal adhesions) had thorough bacteriologic studies, including Chlamydia trachomatis cultures, of their lower and upper genital tracts. Peritoneal or tubal fluid cytologic features and biopsies of fallopian tubes or adhesions were also studied after each laparoscopy. The serum of each woman was titrated for evidence of C. trachomatis infection. The sera of a control group of 51 women with ovarian infertility but normal fallopian tubes according to laparoscopy and hysterosalpingogram were titrated in an identical manner. The current study confirms previous studies that showed a strong correlation between infertility due to fallopian tube factors and positive C. trachomatis cultures or serologic studies. The current study suggests that C. trachomatis infection does not correlate with a past history of salpingitis or pelvic pain, but that current C. trachomatis infection, as assessed by positive culture, does correlate with gross and histologic evidence of chronic inflammation.