Tubal ligation is a commonly used routine procedure for female sterilisation. It is promoted as a very safe and highly effective method of permanently controlling fertility. Yet, since the early 1930s, there have been reports in the medical literature indicating that there are both short-and long-term problems with the procedure. This article reviews the medical and scientific literature in which these problems are reported in an attempt to synthesise and make sense of the results and their implications for women. Contrary to the way it is promoted, tubal ligation is fraught with complications which place at risk the health and well-being of many women. Its sequelae includes many gynaecological problems ranging from torsion, hydrosalpinx, and endometriosis to irreversible interferences with the endocrine system. It is clear that tubal ligation is not the ‘clean cut’ procedure that it purports to be, and, in the interests of women, the myths about safety and efficacy need to be publicly dispelled.