Malignant germ cell tumors of the ovary constitute fewer than 5% of all ovarian cancers. Malignant mixed germ cell tumors (MMGCTs) may secrete tumor markers including alpha-fetoprotein (AFP) and b-human chorionic gonadotropin (b-hCG) depending on the type of tumor cells. Because these tumors are almost always seen in the reproductive period, their differential diagnosis with beta-hCG secreting ectopic pregnancy is of importance. The patient with MMGCT may present with abdominal pain, vaginal bleeding and pelvic mass similar to an ectopic pregnancy. Here, we present a case of MMGCT, which was referred to our clinic with the admission diagnosis of ectopic pregnancy. However, serum AFP level was exceedingly high (2,172 IU/ml), and transvaginal ultrasonography demonstrated an atypical solid mass 6 cm in diameter. As a result, a hormonally active germ cell tumor of the ovary needed to be considered in the differential diagnosis of ectopic pregnancy.