Objective To explore the rationale therapy method of hysteroscopic surgery for cesarean scar pregnancy. Methods A retrospective review of medical records of 64 patients with cesarean scar pregnancy admitted in Shengjing Hospital of China Medical University from January 2006 to April 2009 was performed, 27 cases out of them were referred from other institutions, and received various interventions before admission, while 37 cases were admitted to our hospital without prior treatments. Results The diagnosis was confirmed by serum human chorionic gunadotropin-beta subunit (β-hCG) and ultrasound.Sixty-three patients were removed of conceptive tissues underwent hysteroscopy assisted by ultrasonic guidance, while 1 patient underwent hysteroscopic removal of conceptive tissues assisted by laparoscopic surveillance. Seven cases of sixty-four were experienced second salvage operation. Pathological examinations were performed for all cases and 1 case was diagnosed to be choriocarcinoma. Conclusion Hysteroscopic removal of conceptive tissues implanted in the cesarean section scar seems to be a feasible and safe procedure that might be considered as a treatment option and it should be monitor the levels of β-hCG and the residual lesions after surgery.