Laparoscopic treatment of tubal pregnancy is safe and effective. It permits performance of both radical and conservative procedures. Irrespective of the mode of access, conservative procedures carry the risk of retention of trophoblastic tissue. Systemic methotrexate administration is effective in the treatment of retained trophoblastic tissue, especially if the diagnosis is made early, preferably within the first postoperative week. The subsequent reproductive outcome appears to be the same, irrespective of the mode of access (laparotomy or laparoscopy) by which the procedure is done.