Intermyometrial pregnancy is a fertilized egg that lays in the myometrium of the uterine wall, grows and develops, not planted in the uterus, but surrounded by the myometrium, not connected to the uterine cavity, not connected to the tubal lumen, no small sacs on the uterus, no diverticula, and no congenital malformations. Patients often complain of abdominal pain and are hospitalized with examination revealing intra-abdominal bleeding. An accurate diagnosis is often not made prior to surgery. The authors have worked for more than twenty years and have managed four cases of intermyometrial pregnancy. Now, a brief summary of the management is presented. The first two patients were treated at similar times and their conditions were similar. Both of them were first aborted at the local hospital because of the ultrasound indication of early pregnancy, and the local doctors failed to perform aspiration twice or thrice, and then failed to perform ultrasound-guided aspiration, so they were puzzled and invited for consultation. The fetal sac was visible at a distance of 3-5 MM from the uterine cavity, and the probe seemed to be able to almost reach the fetal sac. In contrast, no pregnancy was seen in the uterine cavity on hysteroscopy. The embryonic sac was seen intact after hysteroscopic dissection of the myometrium under ultrasound localization, and the pregnancy was electrically removed. In two recently treated patients, one also had a failed visualized painless abortion for early pregnancy and one had a refractory miscarriage with no chorionic villi after clearing the uterus, and the diagnosis was clarified after ultrasonography guided by a uterine probe. All of them were admitted to hospital for hysteroscopic surgery. The results were very satisfactory.