BACKGROUND: The purpose of this study was to propose a new method for imaging the uterine cavity and Fallopian tube patency by three-dimensional dynamic magnetic resonance hysterosalpingography (3D dMR-HSG) and to analyse if, by using a higher viscosity contrast solution, direct visualization of the Fallopian tubes may be achieved by this new technique. METHODS: 10 consecutive infertile women underwent 3D dMR-HSG and conventional HSG as gold standard. 3D dMR-HSG consisted of injection of 20 ml of a gadolinium-polyvidone solution into the uterine cavity while acquiring five consecutive three-dimensional (3D) T1-weighted MR-sequences. RESULTS: In three patients the catheter became dislodged during 3D dMR-HSG. However, in one of these patients the examination was still partially diagnostic. Imaging findings of 3D dMR-HSG showed good correlation with conventional hysterosalpingography and allowed 3D imaging of the uterine cavity and of Fallopian tube patency in 8/10 patients and direct visualization of the Fallopian tubes in 5/7 patients. CONCLUSION: 3D dMR-HSG represents a new and promising imaging approach to female infertility causing less pain and avoiding exposure of the ovaries to ionizing radiation. By using a higher viscosity MR-contrast agent it allows not only visualization of uterine cavity and Fallopian tube patency but also direct visualization of Fallopian tubes.