Intramural ectopic pregnancy is one of the rarest types of ectopic pregnancy, with risk of 1:30000. Confirmation of intramural ectopic pregnancy is difficult and is often performed intraoperatively. Intramural ectopic pregnancy often requires hysterectomy to avoid life-threatening haemorrhage. We present a case of intramural ectopic pregnancy in the second trimester, including its diagnostic criteria and treatment plan. Transvaginal ultrasound and MRI are important non-invasive methods in diagnosing this type of ectopic pregnancy. Clinicians should provide consideration to a combination of strategies and do their best to preserve patients' uteri and fertility. In this case, clinicians excluded the gestational sac, repaired the uterus and saved the patient's fertility.