Ectopic pregnancies have a negative impact on future fertility. Prompt diagnosis is paramount to preserve tubal function and reproductive potential. Expectant, medical, and surgical management of ectopic pregnancies have similar efficacy in properly selected patients. Medical management has emerged as a safe alternative to surgery and holds promise for preservation of future fertility. Laparoscopic salpingostomy or salpingectomy remains the preferred means of surgical removal of ectopic pregnancies. The most predictive factor of future fertility is the health of the contralateral tube.