Abstract This paper examines some problems involved in the provision of female sterilization procedures in Brazil, mainly those concerned with the ways in which this operation is offered. Female sterilization provision is analysed by reference to the broader institutional context and from the client's perspectives. These themes are discussed in the light of some recent survey findings. A survey was carried out between March and July, 1992 in two selected poor areas of Sa˜o Paulo Metropolitan Region. 3149 women were asked about contraceptive use including 407 sterilized women under 40 years old who were also interviewed about their adaptation to sterilization. Further information was also obtained through in-depth interviews with 15 sterilized women who regretted the operation. The findings highligh a complex network of interests and misunderstandings which shape the nature of choice of female sterilization by Brazilian low income women.