Purpose of review <p>Asherman syndrome is characterized by scar tissue or adhesions in the uterus, leading to menstrual irregularity, pelvic pain, infertility, and recurrent pregnancy loss. This review provides a comprehensive update on what is known about Asherman syndrome—etiology, risk factors, incidence, diagnostic approaches, surgical techniques, strategies for prevention, and reproductive outcomes.</p> Recent findings <p>The most common cause of scar tissue formation is curettage of a gravid uterus to treat miscarriage, postpartum hemorrhage, retained products of conception, or termination of pregnancy. Adhesions can also form in nongravid uteri after infection, myomectomy, septoplasty, or other surgeries that disrupt the basal layer of the endometrium. Hysteroscopy is the gold-standard approach for diagnosis and treatment, as it allows precise localization and lysis of adhesions in the office or operating room. Recent randomized trials and cohort studies have targeted key challenges in the field, including measuring incidence, preventing recurrence, and optimizing long-term reproductive outcomes. Yet, data remain limited on many aspects of care, and we often rely on expert opinion from high-volume centers. Even among experts, there is no clear consensus on how to stage the disease or how to reliably prevent recurrence. Postoperative adjuncts, such as hormonal medications, intrauterine devices or catheters, and hydrogel barriers, as well as novel interventions such as stem cell therapy, are being actively investigated.</p> Summary <p>This review provides clinically relevant information to effectively counsel patients, treat adhesions with an evidence-based approach, alleviate symptoms, and improve fertility. We emphasize the need for continued innovation and research on management strategies and reproductive outcomes.</p>