Extrauterine abdominal pregnancies occur when the fertilized ovum implants directly into the peritoneal cavity. They are rare, with its incidence being just 1 in 10,000 live births worldwide, and only 0.43% of all documented ectopic pregnancies in the Philippines. This poses a challenge in anesthesia because of the risk of massive hemorrhage the abnormal implantation brings about. This case report presents the anesthetic management of a 29-year-old G3P2 (2002) diagnosed case of 26-week and 5-day gestation viable abdominal pregnancy who underwent abdominal fetal extraction under combined general and epidural anesthesia. Along with the utilization of a multidisciplinary approach, goal-directed fluid therapy, and massive transfusion protocol, this management has been shown to be successful and safe for both the mother and the fetus.