This retrospective study determines risks, outcomes, and cost savings in microscopic tubal sterilization reversal done by minilaparotomy. From January 1992 to December 1993, 40 women, as outpatients, had combined laparoscopy and minilaparotomy for tubal anastomosis. The mean operating time was 1.7 hours, mean blood loss was 20 mL, and mean recovery time was 3.2 hours. Thirty-seven patients (93%) were discharged on the same day, two stayed for 23 hours, and one patient required hospitalization for 2 nights. There were no immediate or postoperative complications. Early crude pregnancy rate was 60%, with an 8% ectopic rate. Tubal patency was confirmed in 39 (98%). The average total cost to the patient was $5,200. Microsurgical tubal anastomosis can be done safely and successfully on an outpatient basis, reducing costs and morbidity and accelerating the patient's return to activity.