Introduction: Heterotopic pregnancy is a rare condition accompanied by intrauterine and ectopic pregnancy. Case: Intrauterine pregnancy and a suspicious ectopic focus were observed in a thirty-seven-year-old patient with no risk factors who presented with menstrual delay. The ectopic pregnancy was successfully removed by surgery to preserve the uterine pregnancy. Discussion: This case report discusses the importance of early diagnosis and management of heterotopic pregnancy to avoid both fetal and maternal morbidity and mortality. Conclusion: It is important to evaluate the adnexia along with the uterus in determining pregnancy in patients presenting with menstrual delay. Additionally, laparoscopy is a reliable option in the treatment of heterotropic pregnancy.