Background: Heterotopic pregnancy is a rare clinical condition, but it is increasingly being diagnosed after the common use of ovarian stimulation and the advent of assisted reproductive techniques. Two cases of heterotopic pregnancy, successful laparoscopic removal of one ectopic pregnancy, and a subsequent favorable outcome of the intrauterine pregnancy, are presented. Cases: The first case was associated with ovarian hyperstimulation syndrome following in vitro fertilization and embryo transfer, and the second case occurred after intrauterine insemination. Results: Via laparoscopy, both cases were diagnosed with ruptured tubal ectopic pregnancy, and laparoscopic salpingectomy after evacuation of the hemoperitoneum was performed. The first patient, at 39 and 1/7 weeks of gestation, was delivered of healthy newborn, weighing 3910 g. In the second patient, at 9 and 4/7 weeks of gestation, an ultrasound scan confirmed a viable intrauterine pregnancy. Since then, the patient has been lost to follow-up. Conclusions: Laparoscopy allows for both a differential diagnosis in an uncertain condition during pregnancy, and a favorable outcome of an intrauterine pregnancy. In the light of this, laparoscopy may be the treatment of choice for patients with heterotopic pregnancies. ( J GYNECOL SURG 30:305)