A bilateral tubal ectopic pregnancy is the rarest form of extrauterine pregnancy and is extremely difficult to diagnose due to an initial presentation that is nearly indistinguishable from unilateral tubal ectopic pregnancy. We report a case of a 27-year-old primigravida woman who presented to our clinic with mild cramping and vaginal bleeding following the administration of clomiphene. Ultrasound confirmed the presence of a left-sided ectopic pregnancy. The patient underwent laparoscopy and was found to have a mass in the contralateral fallopian tube. Histologic evaluation of the specimens from both fallopian tubes confirmed the presence of a simultaneous bilateral tubal ectopic pregnancy. While no current guidelines exist for the management of bilateral ectopic pregnancies, we stress the importance of direct visualization of both fallopian tubes during laparoscopy for any suspected ectopic pregnancy.