Aim and objective: Although two-wave pattern of the coronavirus disease-2019 (COVID-19) pandemic was observed in many countries, there is limited information on the impact of both the waves on clinical presentations of ectopic pregnancy (EP) with COVID-19. Therefore, we aimed to understand the impact of the first wave and second wave of COVID-19 pandemic on women with EPs in India. Materials and methods: We conducted a retrospective study at BYL Nair Charitable Hospital (NH), a dedicated COVID-19 tertiary care hospital in Mumbai, India. We analyzed the impact of the first wave and second wave on women with EPs and the challenges encountered for management during the pandemic in our hospital. Results: A total of 1,660 pregnant and postpartum women with confirmed diagnosis of COVID-19 were admitted at NH during the first wave and the second wave of the COVID-19 pandemic. All cases of EP were asymptomatic for COVID-19. During the prepandemic period of 4 years, there were 220 (15.2 per 1,000 births) women with EPs, which was higher compared to seven EPs (6.3 per 1,000 births) during the COVID-19 pandemic. EP rate per 1,000 births during the second wave was found to be 9.6, which is comparatively higher than the first wave (3.8) (p = 0.24). Conclusion: Increased frequency of EPs during the second wave of the COVID-19 pandemic could be due to the new variant of concern B.1.617. 2 (Delta). For ruptured EP, we recommend surgical management with laparotomy as a treatment option as it is useful in reducing the risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection to healthcare workers. Clinical significance: The COVID-19 pandemic is likely to last longer and hence healthcare providers should ensure that pregnant women have access to medical assistance whenever needed.