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Introduction: Infertility is a clinical and social problem affecting 13% to 15% of couples around the world. One of its causes is the pelvic inflammatory disease, induced by several infectious agents, Chlamydia trachomatis standing out amongst them. This infectious agent has molecular mechanisms modulating the host immune response and producing changes in the infected cell to allow it to survive, casing a chronic immunological system response, with consequent permanent inflammation and sequelae such as cicatrices and obstruction of the fallopian tubes. This review was aimed at updating knowledge regarding the immune-biology of infection caused by Chlamydia trachomatis and its relationship with infertility. Materials and methods: A literature review was made using PubMed/MEDLINE, Science Direct and Ovid databases from January 1995 to January 2012, including review articles and clinical studies. Results: It is currently held that immunomodulation characterizing infection caused by Chlamydia trachomatis, the inflammatory mediators implicated in the immune response and possible (though little studied) host genetic susceptibility are closely related to the genesis of tubal infertility. Conclusion: Infertility caused by Chlamydia trachomatis has its origin in a host's immunological response and this infections agent's modulation leading to chronic inflammation, healing and obstruction of the fallopian tubes. [ABSTRACT FROM AUTHOR]