Abdominal pregnancy is a rare form of ectopic pregnancy and is associated with high maternal and fetal morbidity and mortality. The diagnosis of this entity is difficult and is generally delayed. We report the case of a patient with an abdominal pregnancy diagnosed by transvaginal ultrasound in the first trimester of pregnancy. The patient was treated with methotrexate until complete resolution. We provide a review of the literature on the risk factors, diagnostic tests and therapeutic options for abdominal pregnancy.