Introduction: Ectopic pregnancy is the second leading cause for maternal mortality in underdeveloped nations and is diagnosed with a combination of clinical and laboratory parameters. Objective: To study the socio-demographic factors associated with ruptured ectopic pregnancy and to assess the factors associated with near miss event. Methodology: 64 patients were included in a retrospective, cross-sectional observational study conducted at Maharishi Markandeshwar medical college and hospital Solan, Himachal Pradesh after approval from ethical committee detailed history, examination findings, laboratory investigations, ultrasound findings, intraoperative and post operative findings were recorded as well as course and events during the hospital stay were recorded. Results: Women in reproductive age group in herearly pregnancy presenting with abdominal pain, bleeding per vaginum should be ruled out for ectopic pregnancy. On ultrasound location and size of gestational sac with cardiac activity and fluid in peritoneal cavity can be assessed. Previous surgery, abortions or ectopic pregnancy, history of PCOD/ endometriosis/ PID, use of infertility treatment or oral contraception pills are high risk factors for ectopic pregnancy. Conclusion: Ectopic pregnancies are most frequent 3 AM emergencies which if not managed well can lead to near miss mortality.