Heterotopic pregnancy is a rare occurrence whereby a concurrent intrauterine and extrauterine pregnancy exists. It is a difficult diagnosis to make early, and often associated with significant morbidity and mortality from complications if diagnosed late. In this report, we present a rare case of heterotopic pregnancy in a 25-year-old woman who presented with abdominal pain following blunt abdominal trauma, and ultrasound showing haemoperitoneum and a viable intrauterine 10-week gestation. CT scan was non diagnostic and significance of left parametrial contrast was not considered. She was admitted under the general surgical team and underwent laparoscopy showing a ruptured left tubal ectopic pregnancy and partial salpingectomy was performed. She recovered well post operatively and has continued to carry the intrauterine pregnancy without complications. Surgeons and emergency physicians should be aware of this condition and to consider it in female patients presenting with acute abdomen or trauma even in the presence of an intrauterine pregnancy.