ABSTRACT The prevalence of heterotopic pregnancy is increasing worldwide, due to the widespread practice of assisted reproductive technology and the availability of more precise diagnostic techniques. However, spontaneous heterotopic pregnancy is a rare clinical condition where it occurs in a natural conception. It has a historic incidence of 1 in 30,000. We report a case of 30 years old women, gravida 6, para 3, abortion 2 without having any risk factor for ectopic pregnancy who conceived spontaneously and was diagnosed ultrasonographically as heterotopic pregnancy, i.e. with concomitant right tubal pregnancy and intrauterine gestation. The patient presented with pain in lower abdomen and was managed laparoscopically. Due to its rarity, a high degree of clinical suspicion is required to make a diagnosis of heterotopic pregnancy. Thus, we infer that the diagnosis of heterotopic pregnancy should be suspected in all women in the reproductive age, reporting with early pregnancy. How to cite this article Bajwa JK, Mann A, Rudra S, Singh S. Spontaneous Heterotopic Pregnancy. J South Asian Feder Obst Gynae 2015;7(2):83-85.