The use of transabdominal/transvesical sonography in gynecologic diagnosis is limited by the physical properties of the transducers used as well as the lack of sufficient acoustic interfaces. Therefore, delicate tubal structures cannot be visualized adequately. Transvaginal application of a 6.5-MHz transducer probe (with 10-mm crystal) enables the effective use of higher frequencies, enhancing resolution. This higher resolution improves picture quality and increases potential diagnostic power in evaluating the female pelvis in general and the fallopian tube in particular. This reports presents the sonographic picture of the normal and pathologic tube. Tubal pathology should be described in terms of the tubal cavity, walls, and content, as well as location and mobility. The more frequently encountered clinical entities, such as the fluid-filled tube, tubo-ovarian inflammatory processes, and tubal gestation are discussed.