A uterine septum is a congenital abnormality that has been associated with poor reproductive outcome that can be readily corrected by hysteroscopic surgery. For this debate article we argue that all women with a uterine septum should have hysteroscopic septal resection before undergoing any fertility treatment. A uterine septum is a congenital uterine anomaly arising from the failure of canalisation of the uterus during embryological development. Uterine septa are more prevalent in women with a history of pregnancy loss, but not infertility alone, and are associated with an increased risk of first and second trimester miscarriage and preterm birth [1,2]. Diagnosis is straightforward with three-dimensional ultrasound. Adequate assessment of uterine morphology requires concurrent imaging of the external and internal controls of the uterus. Three-dimensional ultrasound facilitates such views and is safer and more acceptable to women than surgical assessment with hysteroscopy and laparoscopy which are required to see the internal and external fundal contours.