Background
A 27-year-old nulliparous woman with a history of subfertility presented to a routine dating scan at 13 + 1 weeks gestation with a history of left-sided abdominal pain.

Key Findings
Both standard transabdominal ultrasound and handheld point-of-care ultrasound (POCUS) identified a probable abdominal ectopic pregnancy (AEP), confirmed by MRI. Intraoperative findings revealed a live pregnancy encapsulated by the omentum with associated haemoperitoneum. Active haemorrhage necessitated conversion from laparoscopy to laparotomy, culminating in a left salpingo-oophorectomy.

Discussion
This case highlights the potential role of handheld POCUS in diagnosing a rare and life-threatening condition. The device enabled immediate, bedside imaging and facilitated rapid decision-making. To our knowledge, this is the first documented case of an abdominal ectopic pregnancy diagnosed using handheld POCUS, emphasising its potential to improve maternal outcomes through early detection and intervention.