A retrospective study of ectopic pregnancies seen in Korle Bu Teaching Hospital from January 1991 to December 1993 was conducted. The incidence was 39.5/1000 deliveries; patients with ectopic were not of lower parity than those with normal pregnancies. The incidence of historical predisposing factors was 11.08%, although findings at operation indicated a much higher incidence of previous pelvic inflammatory disease (PID). Dizziness/fainting and abdominal distension were more frequent than has been reported elsewhere. This was due to a very high incidence of ruptured ectopic pregnancies (98.1%) with mean volume of haemoperitoneum of 1.37 l. 16.3% of patients were misdiagnosed initially. The second commonest site of tubal pregnancy, after the ampullary region, was cornual. The case fatality rate was 27.9/1000, with more than half of the deaths occurring before or soon after arrival in hospital. In order to reduce the incidence of ruptured ectopic pregnancies we suggest, among other measures, that appropriate diagnostic facilities be provided.