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INTRODUCTION: A recent paradigm shift indicates that the origin of ovarian high grade papillary serous carcinoma is the fallopian tube. The American College of Obstetricians and Gynecologists and Society of Gynecologic Oncology now recommend prophylactic salpingectomies as a preferred method of sterilization. This study sought to evaluate current practices of sterilization across U.S. Obstetrics and Gynecology (OB/Gyn) residency programs. METHODS: This is an IRB-approved study. An electronic cross-sectional survey of 13 questions was sent to all OB/Gyn program coordinators for distribution to their residents. There are 5,258 filled residency slots in OB/Gyn for the 2016-2017 academic year. RESULTS: Response rate was 6.4%, with even distribution across years. The majority of residents are in an academic setting (64.8%). For patients undergoing post-partum sterilization, 55% of patients were counselled about bilateral salpingectomy and tubal ligation. Postpartum tubal ligation only is offered at 51% of programs. For non-pregnant patients, 40.6% of residents counsel patients about bilateral tubal ligation, hysteroscopic sterilization and bilateral salpingectomy. The most common procedure performed is a bilateral salpingectomy (47.4%), followed by bipolar coagulation (21.8%), spring clips (19.3%), Silicone band method (6.9%) and hysteroscopic sterilization(4.7%). The most common reason cited for performing ligation instead of salpingectomy was perceived increased surgical risk such as bleeding or infection (45.2%). CONCLUSION: Though limited in our response rates, this study has several important implications. Despite recommended practice changes, prophylactic salpingectomy to prevent ovarian cancer has not gained widespread acceptance for either postpartum or interim sterilization. Many patients treated in residency are uninsured or socioeconomically disadvantaged and such procedures may offer a unique opportunity for cancer prevention.