Ectopic pregnancies have been reported in distal tubal segments following tubal sterilization procedures (Metz KGP, Mastroianni Jr L: Tubal pregnancy subsequent to transperitoneal migration of spermatozoa. Obstet Gynaecol Surv 34: 554, 1979). Conception in these situations has been presumed to occur as a result of recanalization of the occluded segment or via a fistulous communication between the two tubal segments. The possibility of transperitoneal migration of spermatozoa leading to such pregnancies is not often considered and is rarely reported (Metz KGP, Mastroianni Jr L: Tubal pregnancy distal to complete tubal occlusing following sterilization. Am J Obstet Gynaecol 131: 911, 1978). A case is presented here that provides support for this phenomenon.