Introduction A 29-year-old patient with cervical ectopic pregnancy (CEP) presented as "suspected" cervical mass, and irregular vaginal bleeding was directed to a gynecologic oncologist for consultation. During the examination a massive bleeding occurred. After an unsuccessful attempt to stop the bleeding with a balloon catheter and vaginal tamponade, a total abdominal hysterectomy was performed. The predisposing factors, the differential diagnostic possibilities and the clinical approaches in CEP are discussed. Total abdominal hysterectomy is the procedure of choice for treatment of cervical pregnancy under conditions of urgency and life-threatening bleeding. KEYWORDS cervical ectopic pregnancy; massive bleeding, hysterectomy Recently the rate of cervical pregnancy has increased, which can be explained by the most frequent use of assisted reproductive techniques and transvaginal ultrasound examination [4, 5]. Despite the diagnostic possibilities of the contemporary