Between July 1986 and May 1988, all 23 patients with ectopic tubal pregnancies of 5 to 10 1/2 weeks' gestation and with serum beta-human chorionic gonadotropin levels between 51 and 92,610 mIU/ml (first international reference preparation) were treated by operative laparoscopy. Twenty-two (96%) of the ectopic pregnancies were unruptured or leaking and one (4%) was ruptured. Fifteen patients (65%) were treated with electrosurgical linear salpingotomy, and three of these patients (20%) later needed subsequent operative procedures. Six patients (26%) were treated with laparoscopic partial or total salpingectomy, and two patients were treated with either fimbrial expression of the pregnancy or completion of a partial abortion. Twenty patients (87%) spent less than 24 hours in the hospital for successful treatment of the ectopic pregnancy. It is concluded that operative laparoscopy should be considered an alternative to laparotomy or minilaparotomy for the treatment of ectopic pregnancy.