Bilateral tubal ectopic pregnancies which are spontaneously conceived are of rare occurrences. Generally, they are diagnosed intra-operatively. There are no guidelines published till date for their management. There has been a reported increase in the incidence of such cases. We present a review of such cases reported over the last two decades and report a similar case which presented to our hospital with acute abdomen and USG suggested hemo-peritoneum with further intraoperative diagnosis of bilateral tubal ectopic managed by left salpingectomy and right salpingostomy