Background: Infertility is a distressing condition that affects couples’ mental and social well-being. Uterine pathologies such as intrauterine adhesions, cervical stenosis, submucous fibroid, polyps have been reported in women with infertility. Objectives: To compare risk factors of infertility and hysteroscopic findings in women with primary and secondary infertility in Calabar, Nigeria. Methodology: It was a cross-sectional study of 57 women of reproductive age, presenting with infertility in the gynecological clinic that consented to hysteroscopy between August 2019 and September 2020. A structured questionnaire was used to obtain socio-demographic data and hysteroscopy was done. Results: There was no significant difference in risk factors between primary and secondary infertility. Cervical stenosis (100%) (p=0.002) and intrauterine adhesions (89.5%) (p = 0.031) were higher in secondary infertility. History of adhesiolysis (100%) (p=0.011) was a significant risk factor for intrauterine adhesions in women with secondary infertility. Conclusion: Cervical stenosis and intrauterine adhesions contribute significantly to secondary infertility in our environment. The practice of intrauterine adhesiolysis which is most often a blind procedure in our environment is a risk factor for intrauterine adhesions.