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. Copyright (c) 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.