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Abstract Recurrent IVF failures pose significant challenges for both patients and clinicians. This study evaluates the role of laparoscopy in identifying and treating undiagnosed pelvic pathologies in women with repeated IVF failures to improve pregnancy outcomes. Introduction Recurrent IVF failures are distressing and often associated with undiagnosed factors. While routine imaging methods provide some insight, conditions like endometriosis, hydrosalpinx, and tubal blockages can remain undetected. Laparoscopy, a gold-standard diagnostic and therapeutic tool, is critical in identifying such abnormalities and enhancing IVF success rates. Case Study A 31-year-old woman with primary infertility and three failed IVF cycles from another center was evaluated. Her AMH level indicated diminished ovarian reserve, but all other tests were normal. During her current IVF cycle, two euploid embryos were formed after ovarian stimulation. Despite transferring the embryos into a favorable uterine environment, the patient failed to conceive. Diagnostic hystero-laparoscopy revealed inflamed, bilaterally rigid fallopian tubes. Although tuberculosis (TB) tests were negative, she was empirically treated with anti-tuberculosis treatment (ATT). Following treatment, the patient conceived successfully in her next IVF cycle and delivered a healthy baby. Final Diagnosis Primary infertility with recurrent implantation failure caused by undiagnosed bilateral tubal blockages, possibly linked to subclinical genital tuberculosis. Discussion Tubal pathology is a significant contributor to infertility, often missed by routine imaging. Laparoscopy identifies conditions such as adhesions, endometriosis, and tubal blockages that may impact IVF outcomes. Surgical correction of these abnormalities can improve implantation rates. Conclusion Laparoscopy remains a vital tool for diagnosing and treating undetected pelvic pathologies in recurrent IVF failures. It improves pregnancy outcomes and reduces the burden of repeated failed cycles. Further studies are warranted to validate its role in this subset of patients.