Obesity is considered to be a complicating factor in most surgical procedures, but very few studies have investigated whether this is true for tubal sterilization. We used a large international data set to investigate the effect of obesity on tubal sterilization. Each of the 159 women delineated as obese (greater than 50% above the mean ideal weight) was matched with a woman of normal weight on important provider variables such as center, operator, and type of surgical procedure. Incidences of anesthesic, surgical, and early postsurgical complications were comparably low and of a mild nature for both the obese and the nonobese groups. Incidence of surgical difficulties was higher, and as a result, the technical failure rate was also higher and the surgical time longer for obese women than for nonobese women. However, none of these surgical difficulties or technical failures led to serious consequences. The difference in surgical times was small and is probably of little practical significance. It appears that the surgical difficulties of tubal sterilization in moderately obese women can be easily overcome.