The last decade has witnessed an increasing number of reports indicati
ng that ectopic pregnancy (EP) can be successfully and safely treated
with methotrexate (MTX). This review summarizes the results. In large
series, as many as 45% of a population of women with EP has been treat
ed with MTX. Success rates of 82-95% have been achieved. Tubal patency
on the affected side was preserved in 79-91% of the cases. Preliminar
y assessment of subsequent fertility suggests that 47-69% will obtain
an intrauterine pregnancy. Complications have been only few and of min
or importance. However, the majority of reports do not include control
s. Randomized studies are needed to optimize patient selection. treatm
ent regimens, long-term toxicity, future fertility, and cost-benefits.