Transvaginal(TV) sonography uses high-frequency transducer and allows access 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 suspected ectopic pregnancy we studied 56 women during 4 months from January to April 1989. Of 56 patients 46 had an surfically confimed ectopic pregnancy 5 had not an ectopic pregnancy and 5 had not follow up. TV sonography provids definite sonographic diagnosis of ectopic pregnancy including an extrauterine gestational sac 34 cases (74%) extraulterine embryo 9 cases (19.7%) hematosalpinx 10 cases (21.7%) Overall adnexal mass was detected in 38 cases (82,6%) at initial TV sonography and in 44cases (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 developed or growing adnexal mass in 8 among 9 cases. False positive 5 cases were two ovarian cysts one incomplete abortion two parametrial thickening due to previous ectopic pregnancy and salpingectom. TV sonography may improve the govality of patient management be early diagnosis and early surgical treatment so may preserve fertility. In conclusion we may suggest that TV sonogra-phy is an integral part of diagnostic modality in suspected eotopic pregnancy.