OBJECTIVE To report a case where intra-amniotic injection of methotrexate (MTX) was used to terminate a cervical ectopic pregnancy that was resistant to IM MTX treatment. METHODS Case report. METHODS A 31-year-old woman, gravida 2, para 1, presented with painless vaginal bleeding. An early cervical pregnancy was diagnosed by transvaginal ultrasound. METHODS Intramuscular MTX therapy was started without success, and an intra-amniotic injection of MTX under ultrasonographic guidance was performed. METHODS Pregnancy termination. RESULTS Pregnancy termination was successful, without complications or side effects. CONCLUSIONS Local installation of MTX appears to be an effective and safe method; however, choice depends on gestational age, desire to preserve fertility, and, most of all, hemodynamic stability.