Adhesions are a huge burden on health care resources worldwide. Endometriosis, pelvic pain, ectopic pregnancy, tubal infertility, intrauterine and extrauterine adhesions at hysteroscopic and abdominal surgery are day to day issues faced by the practicing gynaecologist. With second, third and even fourth caesarian sections becoming common place, adhesion prevention and treatment has now become a clinical issue for the obstetrician as well.For many years we have been taught microsurgical techniques using meticulous hemostasis, minimal tissue ischemia and prevention of infection to avoid new or recurrent adhesions in our patients. Despite this, little is known about the effectiveness of these procedures. With increasing technology the obstetrician and gynaecologist now has a number of options available to them in the battle against adhesions. Additionally there are an increasing number of procedures that may benefit from adhesion prevention techniques. Barrier techniques to prevent adhesions after caesarian section or intrauterine surgery are relatively new concepts and studies are limited.With increasing restrictions on health spending the costs of these products are restrictive but are the costs of not using them greater? This presentation will discuss the role of adhesion prevention in fertility treatment, pregnancy outcome and caesarean section.