THE infrequency with which one comes in contact with bilateral tubal pregnancy in the literature for the past ten years impresses upon one the rarity of this condition. When an autpentic case is encountered in an Army General Hospital which has only a small Women's Surgical Section, it is likely to attract more than the usual amount of attention. This patient, Mrs. Mabel P., aged 21 years, the wife of an Army sergeant, was brought to the Oliver General Hospital in an automobile by her husband at about 10 :30 P.M., on March 6, 1946. She stated that she was at a dance, and after dancing about ten minutes she experienced a severe pain in her left lower quadrant. This pain very quickly became generalized throughout her abdomen. She became nauseated, vomited, and subsequently fainted. After she had been revived, she noted -a small amount of vaginal bleeding. She was brought to the hospital immediately. On admission, her pulse rate was 80, respiration 15, and temperature 97.8° F. She was seen by the Surgical Officer of the Day who believed she had a threatened abortion. Morphine, an ice cap to the abdomen, and the Trendelenburg position were ordered. She was seen by the gynecologist on the morning after admission. Pain in both shoulders, generalized abdominal pain, faintness, and weakness were her chief complaints at this time. She stated that her last menstrual period had been Jan nary 15, 1946. Previous to this time she had always been regular. In the past two or three weeks she had experienced some enlargement and soreness of her breasts. Also, she had morning nausea on several occasions. She had had one previous pregnancy which terminated two one-half years ago with a normal delivery. A moderately severe toxemia accompanied this pregnancy. She gave no history of any abortions or miscarriages. The physical examination revealed a well-developed woman who was very pale, had an anxious look on her face, and appeared acutely ill. The skin was moist and clammy. The conjunctiva and buccal mucous membranes were very pale. The breasts were moderately firm, with Montgomery glands present. There was an increase in the secondary areolar tissue. Her pulse was regular, thready, and the rate was 152. The blood pressure was 80/42. While making preparations to administer intravenous :fluids, the systolic pressure dropped to 60. Tl1ere were no murmurs, thrills, or enlargement of the heart. The lungs were clear.