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Background:- Incidence of caesarean pregnancy is increasing due to number of caesarean sections. Its an abnormal implantation of embryo within the myometrium and fibrous tissue of previous scar following caesarean section , D &C ,hysterotomy. Diagnosis and treatment of CSP has become a challenge for obstetrician. Case:- 27 years old Rh negative G2P1L1,10 weeks of gestation presented with per vaginal spotting for past 2 days, which referred here as missed abortion. Diagnosis of scar pregnancy was made with transvaginal sonography. As patient was hemodynamically stable, treated with four doses of injection methotrexate. Serial monitoring of beta HCG done to assess the response of injection methotrexate. Despite methotrexate, patient?s Beta HCG level didn?t fall. So, patient was taken for emergency laparotomy. During the procedure, scar ectopic pregnancy was excised with uterine wall closure. Patient was monitored with serial Beta HCG monitoring which in decreasing trends. Patient?s postoperative course was uneventful and discharged on 10th postoperative day. Conclusion:- Caesarean scar pregnancy if diagnosed promptly, can be managed by avoiding serious complications like massive hemorrhage, hysterectomy. It is a rare diagnosis but should be considered in a patient with low lying gestational sac and appropriate surgical history