Objective Study the effect of hysteroscopic surgery in treatment of small mass of caesarean scar pregnancy(CSP).Methods From January 2000 to January 2013,61 cases lesions ≤2.5 cm diameter of endogenous CSP undergoing treatment in Luohe Central Hospital were studied retrospectively.According to different treatment,they were divided into 21 cases in hysteroscopic surgery group,23 cases in methotrexate + operation group and 17 cases in bilateral uterine artery embolism + curettage group.Intraoperative blood loss,operative time,hospitalization time after treatment and β-hCG to normal time were compared among those three groups.Results The surgical blood loss,hospitalization time after treatment,β-hCG to normal time were (49.8 ± 6.2) ml,(3.5 ± 0.8) days,(21.2 ± 2.4) days in hysteroscopic group,(87.0 ±30.5) ml,(12.5 ± 1.0) days,(29.6 ±2.2) days in methotrexate + operation group,the difference was statistically significant (P ＜ 0.05).The operation time were (33 ± 4) minutes in hysteroscopic surgery group and (35 ± 6) minutes in methotrexate + operation group,which did not reached significant difference (P ＞ 0.05).Length of hospital stay after treatment of hysteroscopic surgery group is less than the bilateral uterine artery embolism + curettage group significantly (P ＜ 0.05).Operation time,surgical bleeding and β-hCG to normal time had no obvious difference between hysteroscopic surgery and in bilateral uterine artery embolism + curettage group (P ＞ 0.05).Conclusion Hysteroscopy surgery in treatment of small mass endogenous CSP is effective,shorter hospitalization time,quick recovery.