Ectopic pregnancy (EP) is a diagnosis that is challenging to make. Both the history and clinical examinationbeing neither sensitive nor specific for the diagnosis. The advent of high resolution transvaginal scan (TVS)diagnosed the EP early and can reduce the mortality and morbidity by proper treatment. This was a crosssectional observational study and analysis of 50 patient was done with diagnosis of ectopic pregnancies inHoly Family Red Crescent Medical College Hospital Dhaka from August 2020 to December 2021. Diagnosiswas made from clinical history, TVS, serum β-HCG and patient were managed surgically. The aim of this studywas correlation of TVS findinds of EP with laparotomy findings. 80% of the patients had EP in fallopean tubein TVS whereas it was more in laparotomy about 98% both ruptured and unruptured. On laparotomy, rupturedtubal pregnancy was more 86% than TVS findings 66%.Haemoperitoneum was present in 86% cases in TVSbut it is more in laparotomy 90% cases. Tubo-ovarian mass was found in TVS 16% with slightly lower no ofcase 12% in laparotomy. 4% had ovarian pregnancy in both TVS and laparotomy finding. Exact site of tubalrupture were identified in surgery. Ampulla 48%, cornua 8%, fimbriae 4% were identified but the site can notidentified by TVS. It can be concluded that high resolution of TVS is a diagnostic tool and laparotomy is theprimary treatment approach for EP especially with massive hemorrhage.