Objective: To study the effect of induced endometrial injury on the pregnancy and implantation rates in patients undergoing intracytoplasmic sperm injection (ICSI) cycles. Study Design: Randomised case control study. Setting: University hospital's fertility clinic. Materials and Methods: A total of 240 women undergoing ICSI cycles were randomly divided into three equal groups, Group A underwent endometrial scratching by pipelle, group B underwent hysteroscopic endometrial injury, and group C were controls. Results: No difference was seen between the groups in terms of age, BMI, endometrial thickness, number of oocytes retrieved, or number of embryos transferred. Pregnancy rate was similar in groups A and B, which was higher than group C, but the difference was not statistically significant. Implantation rate was significantly higher in both groups A and B than controls, and significantly in group B compared to group A. Conclusions: Endometrial injury, especially if induced by hysteroscopy, might be helpful to increase the implantation rate in cases undergoing ICSI-embryo transfer (ICSI-ET). Pregnancy rate however did not change.