Early pregnancy problems form a major part of all gynaecological emergencies. Approximately one in five pregnancies will end in pregnancy loss. The model of care for all early pregnancy events and complications provides the timeline base along which the core standards of care elements, care pathways and clinical protocols can support the care provision for best patient experience. Many agents, including prostaglandins, mifepristone, potassium chloride and dactinomycin, have all been used for the medical management of ectopic pregnancy. It is vital that only appropriately trained and competent staff should perform transabdominal and transvaginal early pregnancy scans. As an essential component of clinical governance, all early pregnancy assessment units and recurrent miscarriage clinics should have regular meetings to review clinical guidelines and protocols. This would provide an ideal opportunity to discuss audits, to generate research ideas and discuss recruitment to national or international multicentre trials.