Introduction: Ovarian pregnancy (OP) is an uncommon form of ectopic pregnancy that is often misdiagnosed. However, the rupture of the expanding OP can lead to internal bleeding and threaten women life. The purpose of this case report is to discuss the challenge to diagnosing and managing OP, specifically in low-income countries, accurately. Case Report: We report the case of an ectopic pregnancy suspected as being an abdominal pregnancy with a dead fetus in utero on ultrasound and which turned out to be ovarian, discovered intraoperatively in a 22-year-old third parous without known morbid history. Discussion: Due to its rarity, OP remains an isolated and exceptional phenomenon in a woman__ampersandsignrsquo;s life. OP is difficult to diagnose and sometimes lately diagnosed, especially in countries with limited resources as the Democratic Republic of Congo (DRC). Indeed, the lack of adequate imaging and histopathologic equipment, and qualified practitioners in most medical centers do not facilitate the early diagnosis and treatment of OP in those settings. Conclusion: This first reported case of OP in the D.R. Congo confirms the difficulty in making the diagnosis. In case of diagnosis doubts, medical care practitioners should consider directing patients to specialized health care cente