To study the effect of abdominal ultrasound-guided embryo transfer (USG-ET) vs. clinical touch embryo transfer (CT-ET) among Egyptian patients undergoing ICSI procedure on the pregnancy outcomes. Patients and Methods: 853 ICSI cycles were studied. 418 women had USG-ET and 435 had CT-ET. Chemical and clinical pregnancy and implantation rate were assessed. Also the incidence of ectopic pregnancy and miscarriage rate were estimated. Results: The clinical pregnancy was almost doubled by using the USG-ET (RR 1.96, 95 % CI =1.03 to 3.75, P<0.0001). Nevertheless, there were no significant differences in ectopic pregnancy or miscarriage rates between the two groups. Conclusions: Although patient's discomfort is slightly more while using USG-ET, this technique significantly improves the chances of achieving a successful pregnancy.