Objectives: To establish if there is a difference between left and right sided ectopic pregnancy rates and if anatomical position has any relationship to clinical presentation. Previous studies have concluded with either support for Berlind’s theory of ovum transmigration or no proven difference between left or right ovulation and the risk of ectopic pregnancy (1, 2). Methods: Analysis of computerised databases in a tertiary referral centre, from 2002–2013 retrospectively compared the anatomical site of ectopic pregnancy and corpus luteum on transvaginal scanning as well as associated clinical symptoms. Results: We found a right-sided tubal pregnancy in 58.5% (282/482) cases (95% CI 54–62%, P < 0.002). Recurrence of ectopic pregnancy was also more likely to be right-sided 60% (15/25, 95% CI 52–89%, P < 0.02). A classical presentation of pain and bleeding was consistent in 47% (134/282) of right tubal pregnancy or 28% (134/482) of total cases. Left tubal pregnancy had a variable presentation of either no symptoms [35% (70/200)], pain [23.5% (47/200)], bleeding [13%(26/200)] or pain and bleeding (28.5% (57/200)]. In cases where the side of the corpus luteum was recorded, 54% (187/346) were on the ipsilateral side to the ectopic pregnancy, 59% (112/190) for right (95% CI 51–65, P < 0.05) and 48% (75/156) left ectopic pregnancies (95% CI 40–55%). Conclusions: Right-sided ipsilateral tubal pregnancy following rightsided ovulation is more common than left. Left sided tubal pregnancy presented less commonly with classical symptoms and evidence of ipsilateral ovulation and this is being further investigated prospectively.