Background: Primary ovarian ectopic pregnancy is a rare subtype of ectopic gestation that is often diagnosed only after rupture. Here we present four surgically and histopathologically confirmed cases with clinical, radiological, operative, and postoperative details. Methods: This retrospective case series of included patients managed at a tertiary care center. Results: All four patients presented with acute abdominal pain and hemoperitoneum. Surgical exploration revealed a ruptured ovarian pregnancy; all four patients underwent oophorectomy. Histopathological examination confirmed ovarian implantation in accordance with Spiegelberg’s criteria. Conclusion: High clinical suspicion and prompt surgical management significantly reduces the morbidity associated with ovarian ectopic pregnancy. Word count: 714 words, excluding references.