Gabon has one of the lowest fertility rates in Central Africa (116 children per 1,000 women); and ectopic pregnancy occurs in 1 per 62.5 live births. We have studied fertility following ectopic pregnancy with a 5 years follow-up in a cohort of 145 women treated for an ectopic pregnancy in the general hospital of Franceville, Gabon. 17% of these women had an intra uterine pregnancy, 10% had a repeat ectopic pregnancy and 73% were infertile 5 years after the ectopic pregnancy. We compared the fertile group and the infertile group after ectopic pregnancy: the main factors for fertility were the fertility of these women before the ectopic pregnancy and the staging of the Fallopian tube and pelvic cavity. Pelvic adhesions following pelvic inflammatory diseases were correlated with infertility. The main causative agent of infertility after ectopic pregnancy were sexual transmitted diseases and their sequelae and late diagnosis.