Background: Hysterosalpingography (HSG) is the first-line investigation among infertile women in Cameroon. There is a dearth of studies on the use of HSG in Cameroon. The aim of this study was threefold: 1) to describe the indications; 2) findings of hysterosalpingography and 3) factors associated with abnormal findings on HSG at the Douala General Hospital, Cameroon. Methods: We conducted a retrospective descriptive study of 242 files of patients who underwent hysterosalpingography at the Radiology Department of the Douala General Hospital from January 2012 to December 2016. We collected data on the sociodemographic, obstetric variables and indications of HSG using a pretested data collection form. We also interpreted HSG films during the study period. Data analysis was with EPI-INFO version 7. Results: The age range was 19-46 years with a mean age of 33.16 ± 5.45 years. Majority 138/242 (57.1%) were in the age group 30-40 years. The main indication of HSG was infertility 87.2% (211/242). Most of the cases 95.87% (232/242) had abnormal findings at HSG. Tubal and uterine abnormal findings made up 133/232 (57.3%), and 97/232 (41.81%) of cases, respectively. Tubal occlusion and hydrosalpinges were found in 99/232 (42.67%) and 19/232 (8.19%) while uterine fibroids and uterine synechiae were found in 57/232 (24.97%) and 30/232 (12.93%), respectively. The factors independently associated with abnormal findings at HSG were: a history of recurrent pregnancy loss (AOR 2.95; 95% CI: 1.19-7.32, p = 0.02) and infertility (AOR 0.24; 95%