Hysterosalpingogram a common radiological examination is routinely used in the investigation of infertility and sub-fertility in women. The close proximity of the uterus to adjacent pelvic structures results in various types of pelvic fistulas after pelvic disease, pelvic radiation therapy, trauma or pelvic surgery. The case of a 34 years old Para 0+1 woman with a diagnosis of secondary infertility and booked for hysterosalpingogram as part of the routine work-up is presented. There was a positive history of chronic pelvic inflammatory disease, myomectomy and appendicectomy. The result showed evidence of opacification of the right fallopian tube with contrast outlining the adjacent large bowels. Asymptomatic pelvic fistulas maybe a silent cause of infertility, and association can only be stated as all other factors of infertility could not be convincingly ruled out.
