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STUDY OBJECTIVE Retained products of conception (RPOC) may occur following delivery or abortion, often necessitating operative hysteroscopy for their removal. A preoperative diagnosis of RPOC by ultrasonography is not always accurate and may lead to unnecessary surgical procedures. We sought to evaluate whether serum level of β-human-chorionic-gonadotropin (β-HCG) may aid in the preoperative diagnosis of RPOC. DESIGN Prospective cohort study. SETTING Gynecology department in a university affiliated medical center. PATIENTS Women undergoing operative hysteroscopy for removal of RPOC between 12/2019 and 1/2021. INTERVENTION Operative hysteroscopy for RPOC removal. Serum β-HCG level were obtained on the day of surgery, and level ≥5.0 mIU/ml were considered positive. All operative specimens were evaluated by pathology for the presence of trophoblastic tissue. MEASURMENTS AND MAIN RESULTS Of the 105 women recruited to the study, the operative pathology showed trophoblastic tissue in 81 (77.1%) cases, and they were included in the data analysis. The β-HCG level was positive in 16 (19.8%) of those 81 cases. Positive β-HCG level was significantly associated with RPOC following an abortion (surgical or medical) compared to RPOC following delivery. In addition, the mean RPOC mass was larger in the β-HCG-positive group compared with the β-HCG-negative group (29.1 ± 9.5 mm versus 23.8 ± 8.9 mm, respectively, P=.004), and the interval from termination of pregnancy to surgery was shorter (4.8 ± 1.7 weeks versus 7.5 ± 2.1 weeks, respectively, P<.001). Relatively high β-HCG level (352 mIU/mL and 3561 mIU/mL) were found in two cases in which the RPOC mass was implanted on a previous cesarean section scar. CONCLUSION β-HCG level is non-contributory to the preoperative diagnosis of RPOC.