Objective To compare the clinical efficacy and security between conservative surgical treatment /salpingostom and salpingectomy for tubal ectopic pregnancy. Methods From January 2014 to June 2016, totally 67 patients with tubal ectopic pregnancy treated in the 7th People's Hospital of Changzhou were studied retrospectively. 26 patients were treated with salpingostom, while 41 patients were treated with salpingectomy. The following clinical parameters were compared, including age, number of conception, pregnancy sac position, pelvic adhesion, abdominal cavity blood loss, the decrease of serum HCG, the incidence of persistent ectopic pregnancy, tubal patency and menstruation recovery. Results In salpingostom group, the age, number of conception and volume of abdominal cavity blood loss are lower than in the salpingectomy group (P<0.05). Most tubal pregnancy in two groups are ampulla pregnancies, serum HCG drops obviously at the third day after surgery in two groups, more obvious in salpingectomy group (P<0.05). No case of persistent ectopic pregnancy in two groups, while nine patients in the salpingostom group were treated with tubal injection of methotrexate (MTX) 30 mg. Patients in the salpingostom group were treated with hystero-salpingography postoperative with 14 cases of the operation side were unobstructed. Menstruation recovery of patients in two groups has no obvious difference (P>0.05). Conclusion Both salpingostom and salpingectomy for tubal ectopic pregnancy could be effective and safe. For the younger or the patients intending to retain the integrity of the fallopian tube could be treated with salpingostom , and the tubal injection of MTX in the operation may help to prevent the occurrence of persistent ectopic pregnancy.