Background: Primary hepatic pregnancy is a rare, but potentially fatal extra-uterine (ectopic) pregnancy. Most cases are missed in early pregnancy and frequently result in acute abdomen and hemorrhage during the first trimester. Only two cases reported were diagnosed prior to ten weeks of pregnancy. Case Report: The authors report one case of six-week primary hepatic pregnancy with timely diagnosis and subsequent evaluation by abdominal ultrasonography and describe the blood supply increasing of early hepatic pregnancy in 72 hours by color Doppler imaging. Discussion: Hepatic pregnancy progresses rapidly and the rupture risk increases day by day due to the rapid vessel-growth. When pelvic US fails to identify ectopic pregnancy, the present authors recommend a thorough abdominal US scan to expedite location of the gestational sac (GS) as early as possible. This is the mainstay of management to avoid serious potential complications. Lack of awareness about this condition may lead to missing or delaying diagnosis. Conclusion: It is very important that the clinician be aware of this condition with a high level of suspicion when pelvic US fails to locate the ectopic pregnancy.