Approximately 12-15% of couples are considered infertile and seek medical care. This review will delineate the current etiologies of infertility and outline a detailed evaluation. Treatment of the infertile couple should be targeted towards specific causes with empiric therapies reserved for those with unexplained infertility. Currently, great advances in the area of assisted reproductive technology allow physicians to treat couples with severe male factor infertility and tubal disease who previously had little hope of conceiving. The most common etiologies of infertility include tubal and peritoneal disorders, ovulatory dysfunction and male factor. Other conditions causing infertility are mentioned in this review for completeness sake. Surgery often corrects infertility due to tubal and peritoneal disease while a variety of medications exist to successfully manage ovulatory dysfunction. Couples who fail to conceive with those conservative measures are candidates for assisted reproductive technology such as in vitro fertilization (IVF). Recent advances in IVF lab techniques allow for correction of severe male factor infertility through use of intracytoplasmic sperm injection.