Aim: We determined the prevalence and factors associated with couple infertility in three hospitals in Douala, Cameroon. Methods: We conducted a cross-sectional study from December 18th 2015 to March 18th 2016 in three public hospitals in Douala. Three hundred and sixty participants were studied prospectively for associated fac- tors using a multivariate logistic regression model and 4732 files were studied retrospectively for the prevalence of infertility. Statistical significance was set at p < 0.05. Results: The prevalence of couple infertility was 19.2%. In logistic models, the factors which independently increased the risk of couple infertility were a history of reproductive tract infection/STI, a history of uterine fibroids, a history of dys- menorrhea and abortion for the females while for males it was a history of mumps, erectile dysfunction and exposure to chemicals/toxic substances/pesticides. Conclusion: One in every five couples in this study was infertile. Several factors affect the risks associated with couple in- fertility. The identification of these factors could help detect subgroups of couples at high risk of infertility. Reproductive health education, screening programmes for STI’s that may lead to infertility should be offered to couples. Keywords: Couple infertility; prevalence; associated factors; Douala; Cameroon.