Laparoscopic sterilization under local anaesthesia was found to be a safe and effective procedure and the most popular method of voluntary sterilization in rural India. The difficulties encountered included omental emphysema and prolapse, bleeding from the mesosalpynx, cervix and abdominal wound, oedematous fallopian tubes and their bisection. In 3 cases, Verres needle penetrated the colon but it was diagnosed before inserting the trocar and cannula. Cardiac and respiratory arrest occurred in one case each but the patients could be revived and there was no mortality. In 3 cases, laparoscopy had to be abandoned because the laparoscope could not be passed into the peritoneal cavity. The failure rate was 0.5 percent.