Heterotopic gestation, characterized by the presence of combined topic and ectopic gestation, until recently was considered to be a rare event occurring in 1:30,000 pregnancies. With the appearance of assisted reproduction techniques, this incidence increased to 1:100-500 gestations. Early diagnosis is difficult and frequently is made when the uterine tube has already ruptured. It's presented a case of heterotopic pregnancy diagnosed by means of a clinical presentation of hemorrhagic acute abdomen, with good progression of the topic gestation that resulted in birth. It's pointed out the importance of considering this pathology in the evaluation of women submitted to in vitro fertilization, with the objective of early treatment.