AbstractSimultaneous bilateral ectopic pregnancies occur-ring spontaneously or following assisted conception tech-niques, although rare, present the clinician with diagnostic
uncertainty and management dilemmas which may have an implication on the patient’s future fertility. A review of avail-able literature suggests that there is no universally accepted management strategy towards this condition, and care needs to be tailored to the needs of the patient, patient’s preferences and the clinical picture. We report two such rare cases of simulta-neous bilateral ectopic pregnancies with different manage-ment and outcomes highlighting the fact that these cases not only pose diagnostic and management challenges but also has complex ethical issues associated with it.