To estimate trends in the ectopic pregnancy rate and treatment pattern in South Korea during 2009. We analyzed national patient sample (n=599,186) from South Korean National health insurance, and rate of ectopic pregnancy among pregnant women on 2009. We also estimated the proportion of cases that were treated operation, or methotrexate. We identified 1,595 ectopic pregnancies during 2009. The rate of ectopic pregnancy among pregnant women was 36.09±3.27 per 1,000 reported pregnancies by diagnosis code and 16.60±1.04 per 1,000 reported pregnancies by surgical or methotrexate treatment. Age group was risk factor for ectopic pregnancy (p<0.01, Chi-squared Test for Trend in Proportions) and low social economic insurance group was high about ectopic pregnancy rate (p<0.01). The surgical and methotrexate treatment were 40.1±3.9%, 6.0±1.4%, respectively. The methotrexate failure rate was 30.7±9.0%. Ectopic pregnancy sites by operation code were tubal or ovarian (90.2±1.8%), cornual (6.0±1.6%), cervical (2.8±1.0%), abdominal (1.0±0.6%). We found that methotrexate failure rate is higher to previous reports and old age increase the rate of ectopic pregnancy. The low social economic insurance group was higher rate for ectopic pregnancy.