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Early diagnosis of an abdominal pregnancy is difficult since it is associated with a wide range of signs and symptoms. However, ultrasound is the most effective method for diagnosing an abdominal ectopic pregnancy. We present a case of advanced abdominal ectopic pregnancy, which progressed to the second trimester and ended up with fetal death. Despite having repeated ultrasound scanning, the diagnosis was missed. This case report emphasizes the need for a high index of suspicion and correlation of the patient's signs and symptoms with ultrasound findings to make an early diagnosis of abdominal ectopic pregnancy. [ABSTRACT FROM AUTHOR]