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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.