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Heterotopic gestation is a very rare entity in natural conception, occurring in only 1 in 30,000 spontaneous pregnancies. A high index of suspicion is necessary for the timely diagnosis and appropriate intervention. We report the case of heterotopic pregnancy in a 32-year-old female presented with hemoperitoneum from ruptured tubal pregnancy with live intrauterine gestation at 6 weeks' period of gestation, diagnosed on ultrasound examination.