The study significance of intrauterine fluid collections in patients with ectopic pregnancy, challenging the assumption that such findings reliably indicate a normal intrauterine gestation. The authors demonstrate that intrauterine fluid may represent a pseudogestational sac and should not exclude the diagnosis of ectopic pregnancy without definitive ultrasonographic evidence of a yolk sac or embryo. The findings reinforce the importance of correlating ultrasound results with clinical presentation and serial β-hCG trends to avoid misdiagnosis and delayed treatment.