Background: Ovarian pregnancy is one of the rarest forms of ectopic pregnancy. Diagnosis is based on criteria established in 1878 by Spiegelberg; they require specific pathologic characteristics in order to formally confirm an ovarian pregnancy.
Case: A woman presented with a clinical picture of ectopic pregnancy that, upon exploration, seemed to be ovarian. Although the pathologic picture did not meet the exact definition of ovarian pregnancy, the final pathology and clinical follow-up could not be explained by any other diagnosis.
Conclusion: Considering our experience and other reported cases, we think that the Spiegelberg criteria for the diagnosis of ovarian pregnancy require reconsideration and perhaps modification.