Background: Heterotopic Pregnancy is a rare incidence in natural uninduced pregnancy, presenting about 1/30000 live deliveries. With onset of artificial reproductive techniques and ovulation induction, the overall incidence of heterotopic pregnancy has ascend to approximately 1 in 3900 pregnancies. Other risk factors include a history of pelvic inflammatory disease, tubal damage, pelvic surgeries, mullerian duct abnormality and prior tubal surgery. Case report: We report a rare case of spontaneous Heterotopic triplet pregnancy in which an ectopic pregnancy in each tube with a single intrauterine gestation. Patient also gave birth to triplet female child by LSCS 6 year back. Conclusion: Heterotopic pregnancy can be a life threatening condition and can be easily missed. Heterotopic pregnancy should be suspected in patients with an adnexal mass, even in absence of risk factors. A high index of suspicion in women is needed for early and timely diagnosis and management with laparotomy or laparoscopy can result in a favorable and successful obstetrical outcome.