Abstract Background: Transvaginal ultrasound and magnetic resonance imaging (MRI) diagnosed a ruptured cornual pregnancy in a female. The patient was successfully treated with manual removal from the rupture site. Case: A 36-year-old woman was referred with a ruptured cornual pregnancy at 12 weeks; there was a positive fetal heart rate. A transabdominal ultrasound scan led to suspicion of an abnormal pregnancy, which was confirmed by MRI. Results: The uterus had ruptured, and the defect was sutured. The patient's postoperative course was uneventful. Conclusions: If unruptured, a cornual ectopic pregnancy is difficult to diagnose in the early stages. Transvaginal ultrasound is a more suitable diagnostic tool than transabdominal ultrasound. MRI was used to confirm the diagnosis of this case. (J GYNECOL SURG 30:35)