Rationale:Ectopic twin gestation involving a complete hydatidiform mole (CHM) and coexisting embryo is an exceedingly rare occurrence.Patient concerns:In this report, we present the case of a 22-year-old female (gravida2, para 1) who was in her 8th week of gestation and presented with abdominal pain. Due to the detection of active bleeding and a ruptured right fallopian tube, the patient underwent a salpingectomy on the right side.Diagnosis:The patient was diagnosed with an ectopic twin gestation involving a CHM and coexisting embryo.Interventions:The patient was treated with right-side salpingectomy.Outcomes:The operation was successful and her recuperation was satisfactory.Lessons:In the management of ectopic pregnancy involving CHM, it is crucial to enhance the accuracy of preoperative diagnosis. Additionally, histopathological examination of the salpingectomy specimen and conceptus is definitely essential for accurate diagnosis and appropriate follow-up management of tubal pregnancies.