Infertility is a major reason for developing mental health problems among women in Africa. Its impact on self-esteem has been the object of increasing attention in recent years. The nature of the relationship between self-esteem and psychiatric disorders remains unclear. It is not yet clear if low self-esteem occurs in some psychiatric conditions, being relatively specific to them or if it is simply representative of poor psychological health regardless of the diagnosis. Therefore, an understanding of a vulnerability factor like self-esteem and its relationship with psychiatric morbidity may be useful in primary prevention of some mental disorders in infertile women. This study is aimed at determining the relationship between self-esteem and psychiatric morbidity among women attending clinic for infertility in the Lagos University Teaching Hospital; to evaluate their self-esteem correlates; to determine the prevalence of anxiety and depressive disorders and the association with self-esteem if any. Two hundred and sixty women of child bearing age between 18 and 49 years with a diagnosis of infertility and no co-morbid medical disorder were serially recruited from three Gynaecologic clinics. Each respondent completed a Socio-demographic Questionnaire and Rosenberg Self-esteem Scale (RSES). First stage screening for psychiatric morbidity involved the use of the twelve-item General Health Questionnaire (GHQ-12). All probable cases (with a score of 3 or more) and 10% of non-probable cases were assessed at second stage interview using the Schedule for Clinical Assessment in Neuropsychiatry (SCAN). The diagnoses of depression and anxiety disorder were made in accordance with ICD-10 criteria. Fertile (Parous), non-pueperal women attending family planning clinic for contraception were used as reference group to determine the normative value of the self-esteem scale in this environment. This was matched with the subjects on age, educational level, marital status and employment status. Majority of the subjects (88.5%) had secondary infertility; 72.6% of these had induced abortion in the past. A quarter of those who had children had more than a single child, and more than three quarters (84.1%) had children of only one gender. Quite a number of subjects (44.6%) reported societal discrimination on account of their infertility. However, previous personal and family histories of mental illness were probably under-reported. When compared with the reference group, the subjects had a higher prevalence of low self-esteem, 50.0% vs 23.1% (x2 = 40.64, df = 1, p< 0.0001) and psychiatric morbidity, 19.6% vs 8.5% (x2 = 13.40, df = 1, p< 0.0001). Depression accounted for more of the psychiatric morbidity in both subjects and reference group. Among the subjects, the prevalence of depression was 16.5% while that of anxiety disorder was 3.1%. Significant associations were found between self-esteem and the following subjects’ variables: Age, Income, Duration of marriage, Supportive husband/partner, Number of living children, Gender of living children and Current psychiatric morbidity (p<0.05). Nonetheless, independent predictors of low self-esteem were current psychiatric morbidity and number of living children. While presence of current psychiatric morbidity was a risk factor for low self-esteem (odds ratio = 7.90, 95% CI= 2.80 – 22.25, p<0.0001), increasing number of children was protective against low self-esteem (odds ratio = 0.50, 95% CI= 0.26 – 0.93, p = 0.03). The only gynaecological/clinical variable which showed significant association with psychiatric morbidity was number of living children (x2 = 5.05, df = 1, p = 0.03). Important independent predictors of psychiatric morbidity include family history of mental illness, having a non-supportive husband/partner and low self-esteem. Risk factors for psychiatric morbidity include having non-supportive husband/partner (odds ratio = 3.51, 95% CI = 1.18-10.44, p = 0.02), positive family history of mental illness (odds ratio = 20.61, 95% CI = 2.80-151.71, p = 0.003) and low self-esteem. Infertile women with low self-esteem had increased risk of psychiatric morbidity compared to those with high self-esteem (odds ratio = 5.71, 95% CI = 2.35-13.91, p<0.0001). There was no significant difference in self-esteem between depressed subjects and anxiety disorder subjects. The relationship between self-esteem and psychiatric morbidity appeared to be a vicious cycle. Efforts aimed at improving the psychological health of women with infertility are required through a liaison between Gynaecology and Psychiatry units.