Interstitial and cornual pregnancies remain the most difficult types of ectopic pregnancy to diagnose and treat. Traditionally, the treatment of interstitial pregnancy has been interventional; a surgical approach that may even extend to a hysterectomy or uterine cornual resection via laparotomy. Recently, and hopefully increas¬ingly, more conservative approaches have been suggested, such as cornuostomy instead of cornual resection and laparoscopy in place of laparotomy, for preserving uterine integrity for future fertility. We present a step-by-step surgical approach that we have implemented in cases of cornual pregnancy in our department.