Background: Intra abdominal pregnancy is one of the rare and life-threatening types of ectopic pregnancy which has been implanted in the peritoneal cavity outside of the uterus, fallopian tube and ovary. An embryo that implants and starts to grow on the viscera or abdominal peritoneum is described as a primary abdominal pregnancy. This article will create awareness of capturing all ectopic pregnancies from the lower level to the higher level health facilities in the country so as to know the magnitude of this problem. Case Description/ Presentations: A 22 years pregnant woman, from mpambaa, kaselya, singida region, the central zone of Tanzania, G2P1L1 with Gestational Age (GA) of 41 weeks and 2 days (by LNMP) was referred from the lower level facility to Singida Regional Referral Hospital for further management, with the referral diagnosis of Intrauterine fetal demise/death(IUFD) diagnosed based on patient history (mother reported absence of fetal kicks) and physical examination(FHR not heard on fetoscope). Diagnosis of intra-abdominal pregnancy based on incidentally intra-operatively findings . The intra-operatively findings concluded the diagnosis of intra-abdominal pregnancy. The patients didn’t do obstetric ultrasound throughout the antenatal visits because the facility she was used to attending Antenatal clinic had no ultrasound. Conclusion and Recommendation: Capacity building to health practitioners in identifying and diagnosing intra-abdominal pregnancy based on clinical manifestations and radiological diagnostic features should be done to all health facilities levels.