Background: In recent years, epidemiological data showed that the incidence of ectopic pregnancies (EP) is decreasing, but few data are available on the time trend in Southern European populations. Methods: Using data from the Lombardy Region Database, we calculated and standardized the EP rates/10,000 resident women and the ratios/1,000 pregnancies. Results: Data regarding 1,777,011 pregnancies and 17,028 cases of EP were recorded among women resident in Lombardy between 1996 and 2010, aged 15-50 years old. The age-adjusted EP rates increased from 4.4 in 1996 to 5.8 in 2010. The age-adjusted EP ratio was 9.4/1,000 pregnancies in 1996 and 9.8 in 2010. Medical treatment increased over the period; the proportion of laparoscopic treatment increased from 25.9% in 1996 to 36.3% in 2010. Conclusion: The age-adjusted EP rate and ratio increased between 1996 and 2010, suggesting that the significance of EP as a public health problem has increased in the last years.