AbstractBackground: Chronic ectopic pregnancy (CEP) is characterized by low serum HCG levels and tolerance tomethotrexate (MTX) treatment. Histologically, CEP is identified by a compact adnexal mass containing degradedchorionic villi, areas of necrosis, and multiple blood clots resulting from recurrent small ruptures in the fallopiantube wall. CEP often manifests as an asymptomatic pelvic mass with low serum hCG levels.Methods: This retrospective study was conducted at the Department of Obstetrics & Gynaecology, VardhamanMahavir Medical College and Safdarjung Hospital, Delhi, India, for one year. The study enrolled pregnant womendiagnosed with chronic ectopic pregnancies between June 2023 and May 2024. Eligible patients from prenatalclinics and labour rooms provided written informed consent.Results: Beta-HCG levels ranged from 3000 to 5000 mIU/ml in 20% of cases, less than 1500 mIU/ml in 3instances, and over 5000 mIU/ml in 1 case. Haemoglobin levels were between 7 and 10 g/dl across all patients.The most common sites of ectopic pregnancy were the ampulla (80%) and fimbria (20%). Surgical salpingectomywas performed in four out of five cases of prolonged ectopic pregnancy. Five patients required blood transfusions:one unit for 60% (3 cases), two units for 20% (1 case), and three units for another 20% (1 case).Conclusion: Clinicians should consider persistent ectopic pregnancy as a differential diagnosis in youngmultiparous women presenting with abnormal uterine bleeding (AUB) and abdominal pain, especially ifultrasound reveals a heterogeneous mass in the pouch of Douglas (POD) and/or adnexa without internalvascularity on color Doppler imaging (CD)