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The T-shaped uterus (U1 in the ESHRE classification) and the septate uterus (U2) are rare uterine malformations. The reference examination for the diagnosis of these malformations is 3D ultrasound, sometimes alongside sonography. The presence of one of these malformations is traditionally associated with a decrease in fertility and an increase in the rate of miscarriages. It also seems to be linked to an increase in the rate of implantation failure in assisted reproduction. Enlargement plasty (or metroplasty) and section of the septum, which are performed by hysteroscopy, are the respective reference treatments for these two pathologies. The surgery is not very high risk, easy to perform, and gives good anatomical results. The impact of surgery on fertility and obstetric prognosis seems to be positive. However, the data in the literature are poor, with studies having a low level of evidence. No randomized trial (except one for septate uterus) has been conducted to date. It is therefore difficult, based on these data alone, to systematically recommend first-line surgery to improve fertility or obstetrical prognosis. In our view, given the positive results in the literature, each situation must be assessed on a case-by-case basis and surgery can be proposed, especially when no other cause has been found.