Objective: To study the operative, anatomic and functional outcome of tactile cold scissor metroplasty (TCSM) as a backup method for hysteroscopic metroplasty. Design: Case series with description of the technique. Setting: Assiut University Women’s Health Center. Patient(s): Three cases with failed hysteroscopic metroplasty out of 127 cases with uterine septa scheduled for hysteroscopic resection. Intervention(s): The TCSM procedure was performed in three cases under direct laparoscopic monitoring. Main Outcome Measure(s): Operative time, complications, hysteroscopic appearance of the cavity, reproductive outcome, and reintervention rates. Results: The TCSM procedure was performed successfully in the three cases with a short total operative time (10-12 minutes). Subsequent office hysteroscopic appearance was satisfactory. Patients were then followed-up for a period of time ranging from 3 to 28 months. One case had a successful pregnancy outcome, one has an ongoing pregnancy, and the last one did not get pregnant so far. Conclusion(s): Tactile cold scissor metroplasty is a useful, safe, and effective backup procedure for hysteroscopic metroplasty.