Ovarian ectopic pregnancy is a rare form of extrauterine gestation accounting for 0.5–3% of all ectopic pregnancies. We present a 25-year-old primigravida at 7+5 weeks period of gestation who presented with a ruptured ectopic pregnancy and hypovolemic shock. Emergency laparotomy revealed a left ovarian gestational sac measuring 2×3 cm. Left oophorectomy was performed with diagnosis confirmed by HPE showing left ovarian stroma with products of conception. Diagnosis was established using Spiegelberg’s criteria. This case highlights the diagnostic challenge of ovarian ectopic pregnancy and the importance of timely surgical intervention.
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