Simultaneous intrauterine and ectopic pregnancies are extremely rare. The diagnosis is usually made by laparoscopy and/or laparotomy. Three cases are presented in which the diagnosis was made during sonographic examinations by simultaneous demonstration of fetal cardiac motion in both the intrauterine and extrauterine fetuses. Early diagnosis of this condition significantly reduces the morbidity and mortality of both the mother and the intrauterine gestation.