Purpose <p>This study aimed to compare reproductive outcomes after laparoscopic tubal anastomosis using conventional (non-barbed) and barbed sutures.</p> Methods <p>This retrospective cohort study was conducted at a single center between January 2016 and December 2021. Thirty-nine women undergoing laparoscopic tubal anastomosis were divided into two groups: a non-barbed suture (5 − 0 polyglactin suture) group (16 women), and a barbed suture (5 − 0 unidirectional barbed suture) group (23 women). Demographic data, operation times, reversal operation success rates, pregnancy rates, and other factors were compared between the two groups.</p> Results <p>The mean operation time was significantly shorter in the barbed suture group (55.8 ± 7.33&#xa0;min) than in the non-barbed suture group (108.7 ± 17.27&#xa0;min) (<i>p</i> = 0.001). The overall pregnancy rate was significantly higher in the barbed suture group (87%) than in the non-barbed suture group (56.3%) (<i>p</i> = 0.037). The rate of intrauterine pregnancy was also significantly higher in the barbed suture group (<i>p</i> = 0.041). The intervals between surgery and pregnancy did not differ significantly between the two groups.</p> Conclusion <p>The use of barbed sutures in laparoscopic tubal anastomosis can result in shorter operation times and better reproductive outcomes than the use of conventional sutures.</p>