AbstractMethods for the sterilization of women by occlusion of the Fallopian tubes have evolved by changes in the approaches to the tubes and trials of various methods for occluding the tubal lumen. Approaches to the tube have included: the anterior abdominal wall routes by laparotomy, minilaparotomy and laparoscopy; a vaginal approach through the posterior vaginal fornix; and transcervical approaches, either blind, or via the hysteroscope. Methods for obtaining tubal occlusion have included: excision and suture techniques; electrocautery; clips and rings; intratubal occlusive devices and chemicals introduced into the tubal lumen. The development of each of the approaches to the tube and of the methods for obtaining tubal occlusion are discussed.