Adenomyosis uteri is often encountered during the workup of infertile women especially who are in their thirties – be it primary or secondary infertility. There are many mechanisms by which adenomyosis results in infertility  eg. dysregulation of the myometrial architecture and functioning along with alteration in the receptivity. Adenomyosis and endometriosis have similar pathogenesis, therefore they co–exist frequently and cause infertility in conjunction with each other. Transvaginal ultrasonography, MRI, HSG, hysteroscopy and laparoscopy aid in diagnosing adenomyosis in symptomatic women presenting with infertility. It is seen that early diagnosis followed by minimal surgical eg. Adenomyomectomy or non–surgical methods eg. MRgFUS for focal adenomyosis carry favourable prognosis in respect to future reproductive potential and good pregnancy outcome whereas diffuse severe adenomyomatosis usually carry poor reproductive prognosis.