Oocyte retrieval (OCR) is the procedure of collecting oocytes from the ovarian follicles. It is one of the most important steps of the in vitro fertilization (IVF) procedure, since the success of IVF is directly related to the number and quality of embryos which in turn are dependent on the number and quality of oocytes. OCR is a generally safe and well-tolerated procedure and is most often accomplished in the patient friendly outpatient setting with conscious sedation and rarely requires general anesthesia. It is typically performed using transvaginal ultrasound guidance, but rarely may require transabdominal ultrasound-guided retrieval in case of abnormal anatomy. In common practice, prophylactic antibiotics are administered prior to the procedure and complications such as clinically significant bleeding or infection are extremely unusual. Approaches of OCR, role of prophylactic antibiotics, vaginal preparation before OCR, instruments for OCR, steps of OCR, role of follicular flushing, complications of OCR, and troubleshooting in OCR are the important topics which are covered broadly in this chapter.