Spontaneous bilateral tubal ectopic pregnancy is the rarest form of ectopic pregnancy. The reported incidence is only 1 in 2,00,000 pregnancies. We report a case of a 36 year old, gravida 3, para 2, live 2, presented with pain abdomen. Ruptured ectopic right side was detected on ultrasound. Laparotomy was done. Right side salpingectomy was done and on inspection during laparotomy a mass of 4×3 cm was found in left tube, with thinned out bulging point suggestive of near rupture. Therefore, left side salpingectomy was also done. Histopathological specimen also confirmed the diagnosis. So, we can conclude that thorough inspection of both tubes during laparotomy and/or laparoscopy is a simple measure to avoid missing this rare life threatening condition.
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