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Introduction Cesarean ectopic pregnancy (CEP) is a rare and potentially life-threatening condition where implantation occurs in the scar of a previous cesarean section. Prompt diagnosis and management are critical to prevent severe complications. Aims and Objectives To present a case of cesarean ectopic pregnancy, highlighting the diagnostic approach, clinical management, and outcome. The objective is to provide insights into effective management strategies for this rare condition. Materials and Methods This case report describes a 37-year-old woman with a history of 1 prior cesarean delivery, presenting with abnormal vaginal bleeding and mild lower abdominal pain at seven weeks? gestation. Transvaginal ultrasound and color Doppler were used for diagnosis, confirming an ectopic implantation within the cesarean scar. Management included an initial dose of intramuscular methotrexate, followed by suction and evacuation due to persistent spotting Clinical data, diagnostic findings, treatment approach, and outcomes were documented. Results The transvaginal ultrasound showed a gestational sac embedded within the previous cesarean scar with active vascular flow on Doppler imaging, confirming the diagnosis of CEP. The initial methotrexate treatment partially stabilized the condition but did not resolve the pregnancy. Subsequently, suction and evacuation successfully removed the ectopic tissue, and hemostasis was achieved. The patient had an uneventful postoperative recovery with no long-term complications. Conclusions This case emphasizes the importance of early diagnosis and a tailored management approach for cesarean ectopic pregnancy. While methotrexate can be considered as an initial conservative option, surgical intervention may be required in cases with significant bleeding or incomplete response. This report contributes to the growing body of evidence guiding CEP management, underscoring the value of multimodal approaches for optimal patient outcomes.