Background and Aims: High in-vitro fertilization (IVF) failure risk in patients with asymptomatic intrauterine pathologies can be diminished with the use of hysteroscopy. This study assesses the impact of pre-IVF hysteroscopy on IVF success in women without infertility pathology and with no history of previous IVF. Methods and Materials: In a randomized clinical trial involving 168 women with infertility history who intended IVF, participants were allocated into intervention and control groups using Balanced Block Randomization. Hysteroscopy, performed 1-2 months prior to embryo transfer, was the intervention. IVF procedures were consistent between groups. Categorical variables were chi-square tested; quantitative ones underwent independent t-tests. Multiple logistic model was used to detect significant factors affecting pregnancy outcome. STATA V.17.0 was use for data cleaning and analysis. Results: Mean age was 31 (±5.02) in the intervention group and 31.14 (±5.10) in the control group (p=0.897). BMI, infertility duration, ovocytes count, hMG injections, and other factors showed no significant between group differences (p>0.05). Finally, 45 (53.57%) women in intervention group had positive βhCG test, compared to the controls (31, 36.90%, p-value = 0.030). Also, the number of positive clinical pregnancies was significantly higher (p-value = 0.045) among the intervention group (32, 38.10%) compared to the control group (20, 23.81%). Multiple logistic regression showed hysteroscopy increased odds of positive clinical pregnancy [aOR: 3.42 (95% CI: 1.18 – 9.96), p=0.024]. Conclusion: Based on our randomized clinical trial hysteroscopy significantly raised the odds of positive clinical pregnancy. This highlights hysteroscopy's potential role in improving successful pregnancy outcomes. These findings offer crucial insights for clinicians and patients in fertility treatments.