Ectopic pregnancy is an increasing health risk for women throughout the world. Recent advances in measurements of serum quantitative beta human chorionic gonadotropin and transvaginal ultrasonography have made it possible to diagnose ectopic pregnancy without laparoscopy. These developments have provided the atmosphere for trials using methotrexate as a nonsurgical treatment for ectopic pregnancy. This article briefly reviews the epidemiology and diagnosis of ectopic pregnancy. The medical management of ectopic pregnancy with methotrexate is then reviewed in more detail.