This chapter examines the evidence and methods of uterine cavity evaluation and the structural abnormalities that may compromise in vitro fertilization (IVF) success. The gold standard method for the evaluation of the uterine cavity is direct visualization with hysteroscopy. One of the most commonly encountered uterine cavity abnormalities is endometrial polyps. Müllerian anomalies are structural developmental abnormalities of the female reproductive system. The American Society for Reproductive Medicine (ASRM) staging system classifies these abnormalities into hypoplastic/agenesis, unicornuate, didelphus, bicornuate, septate, arcuate, and DES-related. Uterine septae form from incomplete absorption of the intervening tissue as the two Müllerian ducts fuse. The arcuate uterus occurs when there is a mild extension from the uterine fundus caudally. Myomas are the most common benign tumor of the female reproductive system. Finally, the chapter describes a comprehensive diagnostic and treatment algorithm for patients with Asherman's syndrome (AS).