A rational approach to the reconstruction of the Fallopian tube, blocked either intentionally or by disease processes, can only be made on the basis of sound anatomical and physiological understanding. It would accordingly not be logical to expect the tube to function normally again after too great a disorganization by sterilization procedures followed by traumatic restorative operations. It is therefore recommended that any sterilization should be carried out by a midtubal atraumatic Pomeroy method, tissue being conserved for possible future reconstruction, and that a proven microsurgical technique be utilized for the best results of reconstruction to be obtained. This paper briefly details the anatomy and physiology of the Fallopian tubes, evaluates a microsurgical tubal repair in the rabbit, reports a series of tubal repairs in women, and suggests a working protocol for future tubal surgery.