In 19 patients the transvaginal (TVU) and in 24 patients the transabdominal (TAU) ultrasound approaches were compared in their ability to identify by visualisation the adnexal mass of ectopic pregnancy. The direct visualisation of ectopic pregnancy (EUP) was 25% in TAU and 94.7% in TVU approach (p less than 0.03). All women had a proven EUP in laparoscopy. TAU approach showed a significant inferiority (p less than 0.02) and TVU a significant superiority (p less than 0.08) in comparison to palpation. 83% out of 43 women had spotting. Unspecific signs for EUP like retrouterine fluid was seen in 20.9%. Line formed endometrium was seen in 6.9%, in 37.2% the thickness of endometrium was under 10 mm, in 55.8% more than 10 mm. An intrauterine pseudo-gestation sac was detected in 6.9%, corpus luteum formation in 37.2%. With vaginosonography organs can be seen at close range, therefore it is easier to recognise the specific signs of EUP - an extrauterine ring - formation surrounded by a dam-like structure of the tube.