This study describes the diagnosis and treatment of a spontaneous intramyometrial pregnancy by a case report and review of the literature at a university hospital center. A 24-year-old woman presented with a spontaneous intramyometrial pregnancy without any previous uterine surgery. Successful laparoscopic resection and myometrial correction were performed. The presence of trophoblastic tissue was confirmed and the myometrium revealed complete healing at postoperative MRI. Intramyometrial pregnancy can occur without previous uterine surgery or uterine manipulation and may be difficult to diagnose. Conservative laparoscopic excision is possible without damage to myometrial integrity.

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