Background and aim: to assess the the posterior colpotomy ap- proach versus laparoscopic approach in the surgical management of ectopic pregnancy in stable patients. Methods: A prospective cohort study conducted on 40 women with ectopic pregnancy, divided into two groups; Group 1 included 20 patients for whom laparoscopic salpingectomy was done and group 2 included 20 patients for whom salpingectomy was done via pos- terior colpotomy approach. Operative and postoperative data were collected and analyzed. Results: Operative time was significantly shorter in group 2; 45 ± 8.1 min versus 56.5 ± 13 min in group 1(P<0.05). Postoperative pain scoring was significantly lower in group 2 (5.7±1.1 vs 6.8±1.6 in group 2 and group 1 respectively) (P<0.05). Urgent laparotomy was performed for one patient in group 1and two patients in group  2 (P>0.05). There was no significant difference between the two groups regarding patient characteristics, clinical data, hospital stay and the need for blood transfusion. Conclusion: Posterior colpotomy is a promising approach for surgi- cal treatment of tubal ectopic pregnancy especially if laparoscopy is not available.