Objective:To explore and compare the therapeutic effect of hysteroscopic cesarean scar pregnancy and transvaginal scar pregnancy.Methods: 63 cases of uterine scar pregnancy patients were divided into treatment group (32 cases) and control group (31 cases) depend on the different surgical methods. The difference of operation time, intraoperative blood loss, HCG descent, postoperative hospital stay and postoperative recovery situation were compared. Results: 32 cases of hysteroscopic surgery patients were successful in one-time operation, no serious complications. Every indicator of hysteroscopic surgery group, such as operation time, intraoperative blood loss, postoperative hospital stay and postoperative blood HCG decline situation, was better than the vaginal surgery group (t=6.743, t=4.329,t=2.482,t=2.181;P<0.05).Conclusion: Hysteroscopy surgery is an important method for minimally invasive treatment of cesarean scar pregnancy, and different individual treatment program should be adopted to treat different cases of CSP and objective in clinical practice.