The success of in vitro fertilization (IVF) has established it as a viable alternative in the treatment of infertility associated with distal tubal occlusion (DTO). In an attempt to adequately counsel patients with DTO as to whether their primary treatment should be microsurgery or IVF, the authors have performed a comprehensive world-wide literature review. Based on what has been published to date, it would appear that patients with mild to moderate tubal disease should be offered salpingoneostomy as their first treatment modality. For patients with severe disease accompanied by extensive pelvic adhesions, salpingoneostomy should be discouraged.