Pregnancy in a rudimentary horn occurs once in 76,000 pregnancies. The most significant threat of pregnancy in a rudimentary horn is the risk of rupture. With the use of ultrasound the diagnosis can be made before symptoms occur. Management usually consists of excision of the rudimentary horn with the pregnancy and the ipsilateral tube, traditionally by laparotomy. We present a case of an 11-week pregnancy in a rudimentary horn with a nonviable fetus diagnosed by ultrasound and treated with laparoscopic resection. Review of the literature revealed 11 cases treated successfully with laparoscopic surgery. Laparoscopic treatment should be considered for pregnancy in rudimentary horn during the first trimester.