Primary ovarian ectopic pregnancy is a rare type of ectopic pregnancy which has an estimated prevalence ranging from 1:7000 to 1:70,000 accounting for almost 3 % of all ectopic cases. A 37-year-old woman was referred to our hospital intermittent vaginal spotting, recurrent abdominal pain that was getting worse, and 3 days of vaginal bleeding with clot passage. Her general condition was good and her vital signs were normal. She felt tenderness in an abdominal examination and had a small amount of vaginal bleeding. Transvaginal ultrasonography showed an ectopic gestational sac, in her right ovary. Our final diagnosis was ectopic ovarian pregnancy and we successfully treated her with methotrexate. After 3 doses of methotrexate administration her beta human chorionic gonadotropin was negative and a sonographic examination was completely normal. Approximately 3% of all ectopic pregnancies are located in the ovaries. Preoperative diagnosis of this extremely rare condition is challenging, because the ectopic pregnancy often resembles cysts of the corpus luteum.
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