Objectives: Caesarean scar pregnancy (CSP) is a very rare and dangerous form of pregnancy because of the increased risk of rupture and excessive hemorrhage. There is currently no consensus on the treatment. We studied if methotrexate (MTX) therapy followed by suction curettage followed by simple catheter was a viable treatment for patients with CSP. Study design: Forty patients with CSP in our hospital received a single dose MTX by intramuscular injection. If gestational cardiac activity was seen on transvaginal ultrasound After 3 days, vacuum curettage was performed to remove the retained products of conception and blood clot (CSP mass) under transabdominal sonography (TAS) guidance. After the suction curettage, a simple catheter balloon was placed into the isthmic portion of cervix. Results: The resolution time of the serum b-hCG was 20.62 5.41 (9–33) days. The time to CSP mass disappearance was 12.57 4.37 (8–25) days. Overall success of the primary treatment was recorded among 40 (37) 92.5% and significantly correlated with degree of vascularity, type of CSP, and beta hCG levels. Conclusions MTX administration followed by suction curettage followed by Foley tamponade was an effective treatment for caesarean scar pregnancy