Analysis of 2,850 consecutive culdoscopies showed that this procedure can be carried out in any patient with an adequate vagina and a free cul-de-sac. Previous pelvic surgery is not a contraindication, as 4 out of 10 patients had histories of major pelvic surgery and 2 out of 3 had histories of chronic symptoms. Regional and local anesthesia have proved effective. Culdoscopy proved the clinical preoperative impression to be wrong in a significant number of patients. Non-palpable, minimal pelvic inflammatory disease and endometriosis were frequent endoscopic findings. The increased accuracy of diagnosis is especially valuable in cases of suspected ectopic pregnancy and in the differential diagnosis of lower quadrant pain in early pregnancy; it has reduced the frequency of laparotomies and transfusions, and has shortened hospitalization in many cases.