Historically ectopic pregnancy and it`s complications account for the most leading cause of first trimester maternal deaths in the world. Bilateral tubal pregnancies in the absence of a preceding induction of ovulation (or tubal manipulation for assisted conception) are very rare occurrences and are associated with high potentials for causing maternal mortality. We herein report an uncommon mode of presentation of an ectopic pregnancy in a multi-parous woman, with a spontaneous bilateral tubal pregnancy. The Patient presented in shock, which was caused by a ruptured right ampullary tubal ectopic pregnancy with massive haemoperitoneum. During a life saving emergency exploratory laparotomy which showed a ruptured right ectopic pregnancy, an enlarged unruptured left ampullary mass highly suspicious of ectopic pregnancy was also removed. Both tubal pathologies were confirmed as ectopic gestations histopathologically. This case underscores the variety of such occurrences, a high index of suspicion, judicious intra-operative inspection of the contra lateral tube and histopathological evaluation of the specimens.
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