As a rare form of ectopic pregnancy, interstitial pregnancy threatens the f
uture fertility of the patient. Methods of management include observation o
nly, medical treatment with methotrexate either systemically or locally, or
surgery either with laparotomy or laparoscopy. We present the case of a wo
man with recurrent interstitial pregnancy. Treatment with methotrexate was
successful in her first interstitial pregnancy, however the second necessit
ated laparotomy. Selection of patients for treatment with methotrexate and
the importance of subsequent tubal investigation are emphasized.