Learning objective To study imaging features, variant, clinical course and management in case of mullerian duct anomaly with ectopic pregnancy. Background Mullerian duct anomalies (MDA) are congenital abnormalities that occur when the Mullerian ducts do not develop properly. A unicornuate uterus with a rudimentary horn is a type of MDA with incidence of 1 in 76,000 pregnancies [1]. Pregnancy in a rudimentary horn of the uterus is a rare clinical condition with a reported incidence of 1 in 100,000 to 140,000 pregnancies [2]. Case & Imaging details A 32 years old female brought by relative with complaints of 6 weeks of amenorrhea with pain in lower abdomen. She was UPT Positive, had h/o miscarriages, rest of her medical history were normal. On ultrasonography scan a gestational sac like structure was seen in right adnexal region with asymmetrical uterus. The possible differentials of tubal/ovarian ectopic pregnancy, unicornuate uterus with ectopic in rudimentary horn and bicornuate uterus with ectopic were considered. On MRI pelvis scan, ectopic gestational sac in non communicating rudimentary horn of unicornuate uterus was diagnosed. The patient was operated and rudimentary horn with Gestation sac was excised. Conclusion MRI has a major contribution to the diagnostic evaluation when pregnancy in a rudimentary horn of uterus is suspected. It should be considered early to decide on further management and planning for surgery. Usually the diagnosis is missed and may present with hemoperitoneum. The standard treatment is surgical excision to prevent complications and recurrence [2].