Transvagina(TV) sonograhy uses high-frequency transducer and allows acces to the uterus and adnexa, provides better resolution and more accurate diagnosis of ectopic pregnancy. To determine the value and the utility of TV sonography for a suspeceted ectopic pregnancy, we studied 56 women during 4 months from January to April 1989. Of 56 patients 46 had an surgically cofirmed ectopic pregnancy, 5 had not an ectopic pregnancy and 5 had not follow up. TV sonography proveds definite sonographic diagnosis of ectopic pregnancy including an extrauterine gestational sac 34 cases (74%), extrauterine embryo 9 cases (19.7%), hematosalpinx 10 ases (21.7%). Overall adnexal mass was detected in 38 cases (82.6%) at initial TV sonography and in 44 cases (95.6%) at follow-up TV sonography. Additional findings were uterine decidual reaction 19 cases (41.3%), pseudo G-sac 4 cases (8.7%),cul-de-sac fluid 42 cases (91.2%). Follow-up TV sonography showed newly develped or growing adnexal mass in 8 among 9 cases. False positive 5 cases were two ovarian cysts, one incomplete abortion, tow parametrial thicknening due to previous ectopic pregnancy and salpingectomy. TV sonography, may imporve the govality of patient management by early diagnosis and early surgical treatment, so may preserve fertility, In conclusion, we may suggest that TV sonography is an integral part of diagnositc modality in suspected ectopic pregnancy.