Two hundred and twenty-six minilaparotomy Pomeroy tubal ligations performed between January, 1976, and July, 1977, are compared to 226 laparoscopic tubal sterilization operations. Operating time, length of hospital stay, and complications were similar for the two groups. Postoperative discomfort was greater in the minilaparotomy group but did not significantly increase the duration of hospitalization and was effectively relieved with oral administration of medication for pain. It is the author's belief that the minilaparotomy procedure provides the best current method of tubal sterilization in the patient who is not massively obese. The slight increase in postoperative discomfort is a small price to pay for freedom from the rare major complications of visceral, vascular, and thermal injuries. In addition the author recently has decreased the postoperative discomfort experienced by carefully expressing the room air from the peritoneal cavity just prior to tying the peritoneal suture.