We describe the case of a 41-year-old white caucasian woman seen in the emergency room due to abdominal pain for the last two days. The pain had appeared suddenly and intensely. Her personal history revealed arterial hypertension and chronic venous insufficiency. The gynecological-obstetric antecedents comprised two pregnancies (with cesarean section), with bilateral tubal block performed on occasion of the last pregnancy. In 2011 the patient underwent LSH due to the presence of a polymyomatous uterus. Surgery was uncomplicated and cervical canal was coagulated to avoid any kind of periodical bleeding.Upon admission, the patient was hemodynamically stable, though the pain was described as being very intense. The gynecological exploration proved particularly painful. No masses were palpable in the adnexal regions. The abdomen proved tender, with localized peritoneal irritation in the hypogastric region. Abdominal and transvaginal ultrasound was performed due to the lack of specificity of the symptoms. An echographic heterogeneous, cystic image with hyperechogenic reinforcement was observed in the left adnexal region, suggesting tubal ectopic pregnancy. Embryonic structures were visualized. Given the strong clinical suspicion, serum beta-HCG was determined, yielding a value of 10,259 mU/ml, which consolidated the diagnosis. Emergency laparoscopy revealed an ectopic pregnancy in the left tubal region, together with hemoperitoneum (500 ml). In view of this finding, which confirmed the diagnosis of ectopic pregnancy, we performed bilateral salpingectomy, with the preservation of both ovaries and sutured the cervical stump to seal the fistula tract. The postoperative course proved normal, with discharge on the fourth day, followed by outpatient controls. The pathology report confirmed the presence of chorionic villi, trophoblastic tubal implantation and hematosalpinx.