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Introduction: Abdominal pregnancy is a rare type of ectopic pregnancy that occurs when the embryo implants in the peritoneal cavity, excluding the fallopian tubes, ovaries, broad ligament, and cervix (1). A secondary abdominal pregnancy takes place when the embryo or fetus develops in the abdominal cavity after being expelled from the fallopian tube during its developmental course, with an incidence of 1 in 10,000 live births (2). Advanced abdominal pregnancy is even rarer, occurring in about 1 in 25,000 pregnancies (3), and is associated with increased maternal and perinatal mortality. Aims & Objectives: Outcomes for a patient with advanced undiagnosed secondary abdominal pregnancy. Material and Methods: Mrs. X a 20-year-old G2A1, at 32 weeks of gestation presented to the emergency department of St. John?s Medical College in Bangalore in an unconscious state. On arrival, her vital signs were non-recordable. CPR was initiated, but even after five cycles, spontaneous circulation was not returned. On examination, the contour of the uterus could not be made out. Auscultation revealed a fetal heart rate of 110 beats per minute. A decision was made to perform an emergency cesarean section in the emergency ward. A midline incision was performed and on opening the abdominal cavity, the amniotic sac was visible just beneath the rectus abdominis muscle with a live fetus in the breech presentation. A live baby boy was delivered by breech extraction with a birthweight of 1.08kg. Upon further examination, the placenta was found to receive most of its blood supply from the ovary, with no additional attachments observed. When attempting to clamp the cord and vascular supply, it was noted that part of the fallopian tube and ovary were included. The histopathology report confirmed these findings. Results: Advanced abdominal pregnancy is a rare condition, occurring in about 1 in 25,000 pregnancies (5). After the delivery of the fetus, the mother experienced a return of spontaneous circulation. Both the mother and the baby were then transferred to the intensive care unit for further management. Conclusion: Abdominal pregnancy is a rare condition that is linked to significant maternal morbidity and mortality. In many cases, clinical and radiological assessments can be misleading. Therefore, maintaining a high level of suspicion, conducting thorough clinical examinations, and ensuring timely interventions are crucial for achieving positive outcomes for both the mother and the fetus.