Background: Compared to laparoscopic sterilisation, the hysteroscopic approach obviates admission, general anaesthesia, surgical incisions and a complication rate of 5 per 1,000 procedures. The use of the new hysteroscopic sterilisation device Essure (Conceptus) for the first consecutive 175 patients, without the use of local or intravenous anaesthesia or any sedation, has been evaluated in the outpatient department (OPD). Results: Successful bilateral placement was achieved in 95% of all women. Pain during the procedure was assessed by a visual analogue score and appeared to be 2.5 on average. All women could be discharged within 1 h; only two women encountered a vasovagal collapse; no adverse events occurred. All women were satisfied with this method. After 1,200 woman-months, no pregnancy was found. Conclusion: Hysteroscopic sterilisation with Essure can be done safely in the OPD without anaesthesia.