Decisions to choose the type of procedure in the management of cornual pregnancy is crucial, these cases will benefit resident physicians and surgeons to decide a primary mode of management among selected patients with cornual gestation and avoid operative procedure which is blood consuming leading to a life threatening condition. They will be enlighten by the advent use of 2D, 3D ultrasound and volume calculation and color doppler ultrasound for early diagnosis to have an effective management of cornual pregnancy and do away with exploratory laparotomy. Review the importance of serum beta human chorionic gonadotropin regardless of the levels in monitoring the effectiveness of this medical approach. Many options in the management of cornual pregnancy would leave a uterine scar and recurrence of another ectopic pregnancy is high and mode of delivery for future pregnancy will be most likely an operative procedure. Therefore this medical approach is recommended.