Background: Embryo transfer (ET) refers to a step in the process of assisted reproduction in which one or several embryos are placed into the uterus of a female with the intent to establish a pregnancy. This technique, which is often used in connection with in vitro fertilization (IVF), has widely been used in animals or human. The aim of this study was to compare Trans abdominal ultrasound (TAUS) with Trans vaginal ultrasound (TVUS) methods for guidance of (ET) regarding clinical pregnancy rate and patient appreciation of pain during embryo transfer. Methods: This prospective, randomized, controlled study was conducted on 100 patients undergoing cryopreserved or fresh morula or blastocyte who were randomized (computer generated program) into 2 groups. Group I (the study group): 50 patients were subjected to embryo transfer under trans abdominal ultrasound guidance and Group II (controlled group): 50 patients were subjected to (ET) under (TAUS). Results: There were no statistically significant differences regarding fresh and cryopreserved. TVUS group demonstrated significant reduction of duration compared to TAUS ones. Minimal pain was observed in TVUS cases compared to TAUS ones. Higher success rate and lower failure rate were demonstrated in TVUS group compared to TAUS group. Conclusions: TVUS seems to have higher success rate with less pain sensation as well as shorter duration of the procedure in comparison with TAUS.