In order to evaluate the effect of the carbon dioxide laser as an adjunct to conventional microsurgical techniques, the authors retrospectively reviewed the charts of 53 patients who underwent tubal reanastomosis after elective sterilization. Thirty-two patients had non-laser microsurgical reanastomosis from 1981 to 1985; 21 patients had microlaser tubal reanastomosis from 1983 to 1985. All patients had unprotected intercourse for at least 1 year. In the non-laser group, 15 were known to have conceived, and in the laser group, eight had conceived; success rates were 43.7% and 42.9%, respectively. It is concluded that the carbon dioxide laser's advantages (precision, hemostasis, and the ability to preserve more normal reproductive tissue), although technically beneficial in performing microsurgical tubal reanastomosis, may not prove to be superior to conventional microsurgical technique as pregnancy rates are compared. Additional long-term studies are needed as more experience is gained to further delineate the role of the carbon dioxide laser for microsurgical tubal reanastomosis.