The fallopian tube contains a muscular wall and plicae lined by ciliated, tubal-type epithelium. While primary tumors of the fallopian tube are unusual, benign, borderline, and malignant tumors occur, many of which have similar counterparts in the endometrium and ovary. Over the past two decades, there has been a realization that the fimbriae are the source of many (and some believe all) cases of “ovarian” high-grade serous carcinoma. The spectrum of serous tubal neoplasia includes p53 signatures, serous tubal intraepithelial carcinoma, and high-grade serous carcinoma. These entities have unique morphologic, immunophenotypic, and genetic features, with varied clinical significance. The fallopian tube is a frequent site of metastatic disease from not only the ovary and uterus but may also contain metastases from distant sites (most often the gastrointestinal tract and breast). Metastases may be located within the serosa, mucosa, muscular wall, or intravascular spaces. The fallopian tube can manifest several metaplasias, such as mucinous and transitional, as well as reactive phenomena, including pseudocarcinomatous hyperplasia. Sexually transmitted diseases are the most common causes of infectious salpingitis, which may result in pelvic inflammatory disease and ectopic pregnancy. Because the fimbriae are a site of serous carcinogenesis, the SEE-FIM grossing protocol was developed to extensively sample the fimbria in risk-reducing salpingectomies and is now applied in many specimens containing salpingectomies, including those from low-risk women. At a minimum, entirely submitting and examining the distal fallopian tube are generally advised.