Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 61 8 2024 02 13 482 484 Athena Behforouz Preventative Gynecology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran Hajar Abbasi Preventative Gynecology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran 2021 03 03 2023 01 22 Heterotopic pregnancy, a rare form of pregnancy, can occur Simultaneously intrauterine and extrauterine. This can be a life-threatening condition and can be easily overlooked if undiagnosed. The patient was a 27-year-old woman, gravid3, para1, live1 and abortion1, at 10 weeks and 1 day by last menstrual period who went to the emergency room complaining of pain in the lower abdomen form 3 days ago. Pelvic ultrasound revealed both live intrauterine and extrauterine pregnancy by gestational age based on the Crown-rump length diameter, 9 weeks and 3 days with moderate to severe hemoperitoneum. The heterotopic pregnancy diagnosis is difficult and requires a high index of suspicion. https://acta.tums.ac.ir/index.php/acta/article/view/9210 https://acta.tums.ac.ir/index.php/acta/article/download/9210/5826