The purpose behind this observational study was to find whether age, parity, ethnicity, uterine position or the mode of presentation (infertility or gynaecological) could be used to predict acute cervicouterine angulation (ACUA) before intrauterine office surgical procedures. Uterine version, flexion and ACUA were recorded after transvaginal scanning in 914 patients and during subsequent examinations in a subgroup of 422 patients. ACUA was tested against presentation, age, parity, ethnicity and uterine position using chi-square and logistic regression. A two-tailed p value <0.05 was considered significant. One hundred and forty-two of 667 nulliparous (21.30%) and 23 of 247 (9.3%) parous women showed ACUA (p < 0.001), which persisted during repeated examinations. More patients with anteflexed (153/767, 19.9%) than retroflexed uteri (12/147, 8.2%) had ACUA p < 0.001. It was more common in Afro-Caribbean (39/179, 21.8%) and Middle East women (37/129, 28.7%) than Caucasians (89/606, 14.7%; p = 0.001). Age and presentation were not significant. Accordingly, ACUA should be considered before office intrauterine surgical procedures in nulliparous patients, especially those with anteflexed uteri. We debate the clinical implications of ethnicity.