Background: The fallopian tube is where ectopic pregnancies most frequently occur. Methotrexate or minimally invasive surgery can successfully treat the majority of early-detected tubal ectopic pregnancy cases.
Objectives:  This study's objective is to evaluate letrozole as a potential new treatment for ectopic pregnancy.
Patients and methods: The Obstetrics and Gynecology Department of Qena University Hospital carried out this cohort study. The study included 40 cases with non-disturbed ectopic tubal pregnancy. They were divided into two groups; group took Letrozole (20 cases), and group took methotrexate (20 cases). The duration of the study ranged from 6- 12months.
Results: as regard success of treatment was achieved in 85% of letrozole cases versus 80% in methotrexate cases with insignificant differences. Maternal morbidity was insignificant between two groups as in letrozole group 2 cases transferred to surgery and 1 case shifted to methotrexate, in methotrexate 4 cases transferred to surgery.
Conclusion: Success rates for both treatment arms of letrozole and methotrexate were 86%.  Even though the difference was statistically significant, women treated with letrozole rather than methotrexate tended to experience a faster decline in B-Human Chorionic Gonadotropin levels.