Key content:• The Confidential Enquiry into Maternal and Child Health report for 2000-02 stated that cornual pregnancy is a rare but dangerous type of ectopic pregnancy.• Four out of the 11 deaths from ruptured ectopic pregnancy were due to ruptured cornual pregnancy. In all four cases the diagnosis was made only after rupture.• Haemorrhage can be severe because pregnancy is often more developed than extrauterine tubal pregnancy and because of the large blood supply to the uterus.• Clinicians should be aware of the difficulties with both clinical and ultrasound diagnosis.• Many case reports have been written about sporadic cases of intact and ruptured cornual pregnancy and several treatment modalities discussed. There are very few publications collecting all management strategies, including both surgical and medical treatment, for this dangerous type of ectopic pregnancy. Learning objectives:• To understand recent advances in diagnosis and conservative laparoscopic and medical treatment.• To review the most reputable case reports discussing all modalities of treatment, including radical surgical and conservative laparoscopic methods and different types of medical treatment, with critical appraisal of each approach. Ethical issues:• How should a couple be counselled regarding future pregnancy risks and the optimum mode of delivery?

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In this paper, we discuss a successful attempt to reduce the incidence of recurrent cornual pregnancy by ipsilateral tubal occlusion in a lady with two previous cornual pregnancies and a healthy looking contralateral tube.

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