Early surgical intervention in ectopic pregnancy is desirable. However, occasionally some patients do not benefit from this approach, as the natural history of ectopic pregnancy is not always tubal rupture or any other catastrophic event. A retrospective as well as a prospective analysis of 144 cases of suspected ectopic pregnancies was performed. The results of this study support expectant management in cases where serum beta-HCG levels are declining, provided the patient is stable and has no acute abdominal symptoms.