Background: Ectopic pregnancy remains a significant obstetric challenge and a leading cause of maternal morbidity and mortality, particularly in low-resource settings. Objective: The basic aim of the study is to find the spectrum of ectopic pregnancies at tertiary care hospital of Ayodhya.Methodology: This retrospective observational study was conducted at Tertiary care hospital of Ayodhya during January 2024 to December 2024. A total of 102 cases were added in the study.Patient data were collected from hospital records, including demographic details such as age, parity, and obstetric history. Patient’s age, parity, and obstetric history, presenting symptoms such as abdominal pain, vaginal bleeding, and hemodynamic instability were noted.Results: The mean age of the patients was 30.5 ± 4.5 years, with an age range of 20 to 40 years. Among the cases, 30.0% were primigravida, while 72.0% were multigravida. Regarding parity, 28.0% of the patients were nulliparous, whereas 72.0% were multiparous.In terms of risk factors, 15.0% of the patients had a history of previous ectopic pregnancy, while 10.0% had undergone infertility treatment. A history of pelvic inflammatory disease was reported in 12.0% of the cases, and 18.0% had a history of previous pelvic surgery. Additionally, 25.0% of the patients reported using contraceptive methods, while 5.0% had conceived through assisted reproductive technology. Smoking was a risk factor in 8.0% of the cases.Medical management was employed in 24.5% of cases, whilethe majority, 75.5%, required surgical intervention via laparotomy.Conclusion: It is concluded that ectopic pregnancy remains a critical concern in obstetric practice, with a high burden of morbidity requiring surgical intervention in most cases.