OBJECTIVE: (a) To estimate the proportion of mesosalpngeal adipose tissue condensation (lipomesosalpnix) among infertile women subjected to diagnostic laparoscopy and (b) to test the feasibility and efficacy of some novel treatment modalities. DESIGN: (a) cross sectional and (b) longitudinal study. SETTING: A specialized endoscopic center. PATIENT(S): All infertile women scheduled for diagnoastic/therapeutic laparoscopy during the period between July 1994 and August 2010 were included in this study. INTERVENTION(S): Preoperative transvaginal ultrasonography as well as BMI for all cases. Laparoscopic documentation of mesosalpingeal condensation of adipose tissue (a). Histopathologic assessment of the adipose tissues of some cases. Bipolar needle coagulation Vs injection of 5 mL of Dermastabilon into the lipomesosalpnix (b). MAIN OUTCOME MEASURE(S): (a) number of cases with unilateral or bilateral lipomesosalpnix and (b) complete disappearance of the mass on proper treatment on second look laparoscopy. Results: Lipomesosalpnix was confirmed in 145 cases (5.7%) out of 2563 cases examined by laparoscopy. In all but 7 cases, lipomesososalpnix was diagnosed bilaterally (99.7%). There was insignificant correlation between those cases and high BMI when compared to the rest of cases. Infertility was unexplained by laparoscopy in 621 cases (24.3%) while laparoscopy diagnosed etiologic factors in 1942 (75.7%) cases. Lipomesosalpnix was seen in 46 (7.4 %) and 79 (3.9%) of the unexplained cases and explained cases respectively without a statistically significant difference (P 0.48). Unexplained infertility cases (46 cases) were divided into two groups according to the treatment modality. Bipolar needle coagulation was performed in 29 cases while 5 mL of Dermastabilon was injected into the lipomesosalpnix in 17 cases. Spontaneous pregnancy was achieved in 4 cases with unexplained infertility within 6 months following bipolar coagulation of lipomesosalpnix. Second look laparoscopy was performed for few cases (ongoing part). Conclusions: Despite being a rare laparoscopic finding, lipomesosalpnix should be reported and documented specially in cases with unexplained infertility. Whether to treat lipomesosalpnix or not and by which means require more studies with proper second look laparoscopy.