Introduction: Heterotopic pregnancy resulting from spontaneous conception is a rare occurrence. Most will present with symptoms and signs similar to an ectopic pregnancy and surgical management with salpingectomy is often required. We present a case of heterotopic pregnancy that we managed in our facility and its subsequent live pregnancy outcome. Case Report: An African lady in her first pregnancy presented with abdominal pain with subsequent investigations revealing a heterotopic pregnancy composed of an intrauterine and tubal pregnancy. She underwent laparoscopic salpingectomy recovering well and carried the intrauterine pregnancy to term with a live birth being the outcome. Conclusion: The case presented is a case of heterotopic pregnancy resulting from spontaneous conception. Surgical management is the preferred method of management and this was required for the reported patient. The outcome of the intrauterine pregnancy is usually good after surgical removal of an ectopic pregnancy and the patient in this report had a relatively uncomplicated pregnancy with a good perinatal outcome. This case adds to the small body of evidence on heterotopic pregnancies, their management and subsequent outcome.