Morbidity and mortality of ectopic pregnancy (EP) have been drastically reduced since the first successful surgical removal of a fallopian tube EP in 1884 by Tait. Diagnosis and treatment were revolutionized by the introduction of quantitative serum beta hCG essay, high frequency transvaginal ultrasound (TVS), laparoscopic surgery, and interventional radiology with uterine artery embolization (UAE). In this paper, the focus will be on TVS diagnosis of EP in various locations. With two-dimensional (2D) color Doppler TVS having established itself as state-of-the-art diagnostic tool for EP, it will be discussed whether the additional use of 3-dimensional (3D) TVS facilitates the diagnosis of EP.