Naturally occurring hetetrotpoic pregnancy is exceedingly rare, but the incidence increases with the Introduction of assisted reproduction. Having delivery of a term baby is exceptionally rare. History, clinical examination and ultrasound without high index of clinical suspicion may be misleading. We report a case of a combined intrauterine and intraabdominal pregnancy, diagnosed at Cesarean section at 35 weeks gestations in a 38-year-old multiparous yielded healthy twin at term. Conclusion: Quantitative risks assessment in high risk group may reduce the physician diagnostic errors.