Twin tubal ectopic pregnancies are rare events but critical diagnoses to make in emergency settings. They are common in patients who received in vitro- fertilization and in those with history of PID. Unless 2 embryos are live with detectable heart beats, ultrasound cannot definitely diagnose twin tubal EP. In clinically stable patients, MRI may provide other concrete findings to establish the diagnosis and lead to better management. In literature, to best of our knowledge, there has been no reported case of twin tubal EP evaluated with MRI. In this article, we have briefly reviewed the role of MRI in different types of EP and its limitations. We report an interesting case of ruptured tubal twin EP diagnosed with MRI which was sub optimally evaluated with ultrasound.
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