BackgroundIntramural ectopic pregnancy is unusual, difficult to diagnose, and associated with a high rate of uterine rupture.CaseA 35-year-old, gravida 3, para 0-0-2-0 was diagnosed with intramural ectopic pregnancy by ultrasound showing a gestational sac surrounded completely by myometrium. It was confirmed by laparoscopy. With expectant management, the gestation resolved spontaneously.ConclusionEarly diagnosis by ultrasound of intramural ectopic pregnancy permits expectant management which, if successful, would aid in maintaining fertility.