During the 1970s in the United States, the number of hospitalizations for ectopic pregnancy increased more than twofold, and ectopic pregnancy emerged as a leading cause of maternal mortality. All known deaths from ectopic pregnancy in the United States from January 1, 1979, to December 31, 1980, were investigated by the Centers for Disease Control to determine incidence, characteristics, and risk factors for fatal ectopic pregnancy. Deaths were reported primarily by state health departments; numbers and characteristics of women who had ectopic pregnancies were obtained through the National Hospital Discharge Survey of the National Center for Health Statistics. Eighty-six deaths were confirmed among an estimated 102,100 cases of ectopic pregnancy, for an overall death-to-case rate of 0.8 per 1000. Women of black and other races had a relative risk of death 3.2 times that of white and Hispanic women. Continued surveillance should help to reduce the number of deaths through the education of women and health professionals.