Background Retroperitoneal ectopic pregnancy is extremely rare. This unusual location represents a great challenge for clinicians due to the difficulties of diagnosis and high risk of life-threatening complications. Case Report We report the case of a spontaneous early pregnancy of undetermined location in a patient with a history of previous laparoscopic surgery. Diagnosis steps using clinical examination, ultrasound, and magnetic resonance imaging led to the localization of the pregnancy, in the left side of the para-aortic region, in the retroperitoneal space. Conclusion Retroperitoneal ectopic pregnancy is an uncommon entity with rather complex pathogenesis. Clinicians should carefully interpret clinical signs, biological findings, and imaging features and be aware of unusual locations such as the retroperitoneum for ectopic pregnancies. Early diagnosis and appropriate management strategy are conditio sine qua non for successful treatment outcomes.

Isolated torsion of a fallopian tube in the third trimester of pregnancy is an uncommon event. Expedient diagnosis warrant a prompt management in view of better postoperative well-being for both mother and the fetus. Therefore, it can be challenging because the symptoms are relatively non specific. The ultrasound findings may be suggestive but the diagnosis is only made after the surgical exploration and histopathology.We present a case of isolated tubal torsion in a primigravida occurring in the third trimester managed by laparotomic salpingectomy.

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