Objective: To report a patient with sterility secondary to severe intrauterine adhesions who underwent sonohysterographic (SHG) lysis for recurrent adhesions following hysteroscopic lysis, and achieved tubal patency and natural pregnancy leading to term vaginal delivery. Design: Case report. Setting: National Hospital Organization Kyoto Medical Center, Kyoto, Japan. Patient: A patient with hypomenorrhea and sterility due to postpartum severe intrauterine adhesions. Interventions: Operative hysteroscopy was performed for the severe intrauterine adhesions, and SHG lysis was performed for each of the recurrent adhesions that had occurred four times. Results: SHG lysis improved the hypomenorrhea and restored the patency of the occluded fallopian tube. The patient became pregnant, and vaginally delivered a full-term infant. Conclusion: This approach may be an option if recurrent adhesions following hysteroscopic lysis occur.