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Title: ROLE OF ULTRASONOGRAPHY IN THE EVALUATION OF FEMALE INFERTILITY IN RURAL TERTIARY CARE CENTER INTRODUCTION: Infertility affects approximately 10-15% of couples worldwide, presenting both a medical and psychological challenge. Ultrasonography (USG) has become an indispensable tool in the evaluation and management of infertility due to its non-invasive nature, accessibility, and high-resolution imaging capabilities. This imaging modality assists in diagnosing the underlying causes of infertility, monitoring treatment responses, and guiding interventions. AIMS: To evaluate the role of ultrasonography in diagnosing various causes of female infertility. OBJECTIVES: To evaluate the frequency of different infertility causes identified using ultrasonography. To determine the role of ultrasonography in assessing ovarian reserve, endometrial health, and uterine anomalies in infertile women. MATERIALS AND METHODS STUDY DESIGN: Cross-sectional observational study STUDY POPULATION: The study was conducted at a rural tertiary care center, where 50 women diagnosed with infertility (primary or secondary) were included. RESULT: Socioeconomic status influenced infertility outcomes, as lower socioeconomic class was common among participants, impacting access to healthcare. Additionally, psychological distress was significant, emphasizing the need for supportive care. In our study, primary infertility was observed in 64% of participants, with Polycystic Ovary Syndrome (PCOS) being the most common cause. CONCLUSIOIN: In summary, ultrasonography is a cornerstone in infertility care, enabling comprehensive evaluation, real-time monitoring, and guided interventions. Its use enhances diagnostic accuracy and facilitates personalized treatment plans, ultimately contributing to improved reproductive outcomes. Further advances in ultrasound technology, such as 3D and Doppler imaging, promise to refine infertility assessments and enhance clinical decision-making, thereby providing a brighter prospect for individuals and couples seeking parenthood.