Heterotopic pregnancy (HP) is a rare event of ectopic pregnancy after natural pregnancy or assisted reproductive technology (ART) procedures, and its pathophysiologic mechanisms have not been clarified. Moreover, it is difficult to diagnose an HP due to the rarity and the asymptomatic nature. Here we present a case of an unexplained infertility woman following in vitro fertilization - embryo transfer (IVF - ET) developed HP — intrauterine pregnancy and tubo - ovarian pregnancy, and managed conservatively by laparoscopic. HP after ART represents an emergency and therefore the intrauterine pregnancy and the fertility potential will be better preserved by improved sonographic imaging and experienced surgical hands.