Ectopic pregnancy with luteal-like echoes seen in the left ovary is usually a physiologic ovarian alteration that refers to the presence of luteal tissue in the left ovary. Luteal tissue in the ovary usually forms after ovulation during the menstrual cycle. The ovarian corpus luteum tissue secretes progesterone, which supports ovarian corpus luteum function and promotes embryo implantation. As human chorionic gonadotropin rises during pregnancy, it can stimulate the formation of gestational corpus luteum cysts in the ovaries. In women, the ovarian corpus luteum forms after ovulation, and if conception occurs during ovulation, the corpus luteum can continue to enlarge into a gestational corpus luteum, or even a gestational corpus luteum cyst, when stimulated by the formation of a fertilized egg, which secretes and maintains progesterone required for pregnancy until it is replaced by the placenta after the 10th week of gestation. If conception does not occur, the corpus luteum will degenerate into the corpus albicans 2 weeks after ovulation. In ectopic pregnancy, although the gestational sac is not in the uterine cavity, elevated human chorionic gonadotropin can still stimulate the ovarian tissue to enlarge the corpus luteum and even form corpus luteum cysts, which is suggested by luteal-like echogenicity in the ovary on imaging.