The aim of this study was to identify the value of hysteroscopy in detection of the relationship between missed miscarriage and intrauterine pathologies. The study was held at the Department of Obstetrics and Gynaecology, Benha University. It included 90 women with 1 st trimester missed miscarriage who were examined by diagnostic hysteroscopy immediately before dilatation and curettage (D&C) and 6-8 weeks after D&C (second look hysteroscopy). Incomplete uterine septum was found in 22.2% of cases; 70% of them had a previous history of missed miscarriage. Intrauterine adhesions were found in 6.7% of cases before D&C and in 16.7% after D&C. In cases of missed miscarriage either before or after D&C, hysteroscopy is an easy and effective tool for diagnosis of the site of the sac and the presence of intrauterine pathology.Abstract