Objective: To report a case of laparoscopic treatment of a heterotopic primary abdominal pregnancy after IVF with preservation of the concurrent intrauterine pregnancy. Design: Case report Setting: University-based IVF program. Patient(s): A woman with a heterotopic abdominal pregnancy after IVF-ET. Intervention(s): Pituitary down-regulation with luteal leuprolide acetate, ovulation induction with menotropins, IVF-ET, progesterone in oil for luteal support, laparoscopy, and resection of the abdominal gestation. Main Outcome Measure(s): Human chorionic gonadotropin levels, pelvic ultrasound examinations, and laparoscopic and pathologic findings. Result(s): A heterotopic abdominal pregnancy occurred after NF-ET and was treated successfully with laparoscopy. The concurrent intrauterine pregnancy was delivered at term. Conclusion(s): Early diagnosis of an ectopic abdominal pregnancy allowed successful laparoscopic treatment, without sequelae to the intrauterine gestation. (Fertil Steril(R) 1998;70:159-60. (C) 1998 by American Society for Reproductive Medicine.).