The aim of the study is to assess the reproductive outcome (conception rate and live birth rate) after hysteroscopic septoplasty using hysteroscopy with scissors compared with monopolar resectoscope. Methods: A randomized clinical trial done at gynecology department at Mansoura university hospital from July 2020 to March 2023. Women with uterine septum and suffering from recurrent pregnancy loss or subfertility were included in the study. 40 patients were eligible to inclusion criteria and were randomized by computer program into 2 groups: resectoscope group and scissors group. Patients were followed up until the end of first clinical pregnancy or for 1 year after hysteroscopic septoplasty. Results: Resectoscope group had conception rate 50% and live birth rate 38.9%, while scissors group had conception rate 57.9% and live birth rate 52.6%. There was no statistically significant difference among the patients of both groups regarding the conception rate and live birth rate after hysteroscopic septoplasty. Conclusions: Hysteroscopic septoplasty improves the conception rate and livebirth rate in patients with recurrent pregnancy loss or subfertility whatever the technique of septoplasty either by scissors or resectoscope.