To report a case of ruptured right heterotopic interstitial pregnancy diagnosed and managed laparoscopically by cornual resection. Case report. University tertiary care hospital. A 29-year-old female Jehovah's Witness patient with first-trimester acute right lower quadrant abdominal pain. Emergency laparoscopy was performed, and the site of bleeding was first clamped with a laparoscopic grasper. The lateral tissue was then coagulated and simultaneously transected with the bipolar-cutting probe for control of hemorrhage. The early diagnosis of heterotopic interstitial pregnancy should enable a conservative approach, whether medical or surgical, to be undertaken when treating this rare and potentially fatal condition. The treatment of a ruptured heterotopic interstitial pregnancy by laparoscopy was successful with cornual resection. Management of a ruptured interstitial pregnancy by laparoscopy was successful with cornual resection and minimal blood loss, and a coexiting intrauterine pregnancy continued satisfactorily.