Abstract: This study aimed at identifying the etiology of infertility among Sudanese couples. This study was a cohort study and it was held in Wad medani city, Gezira state (central of Sudan), the study group was composed of 200 infertile couples presented with infertility to the primary health care units. Demographic and epidemiological data were collected in special questionnaire. Medical history and examination was performed by the health centre doctor, midwife, nurse. Variable investigations were done including; blood, urine, hormonal assay, seminal analysis, histosalpingiography and ultra sounds. Outcome results were 79.5% were suffered from primary infertility and 20.5% had secondary infertility. Infertility due to husbands only was 20% that due to wives alone was 37.5% and infertility due to both couple was 31% while those with unknown aetiology was 11%. Sexual Transmitted Diseases (STDs) were not incriminated as an infertility etiological factor.