The nontubal ectopic pregnancy poses a difficult diagnostic challenge. Improved accuracy in the early diagnosis of these uncommon forms of ectopic gestation and subsequent improvement in outcome for the patient have been made possible by such advances as serum beta-hCG radioimmunoassay and ultrasonography. Future additions to the gynecologic diagnostic armamentarium and an increased awareness leading to a heightened index of suspicion of these rarities may lead to further reductions in morbidity and mortality.