Female and male sterilization are both safe and effective methods of permanent contraception used by more than 220 million couples worldwide . Approximately 600,000 tubal occlusions and 200,000 vasectomies are performed in the United States annually . For women seeking permanent contraception, sterilization obviates the need for user-dependent contraception throughout their reproductive years and provides an excellent alternative for those with medical contraindications to reversible methods. The purpose of this document is to review the evidence for the safety and effectiveness of female sterilization in comparison with male sterilization and other forms of contraception.