ABSTRACT
Development of a gestational sac in a cesarean scar of the lower uterine segment is a rare form of ectopic pregnancy. The incidence of cesarean scar pregnancy (CSP) has risen during the past 5-6 years because of rising cesarean section rates worldwide. The CSP is a dangerous condition, possibly leading to uterine rupture, massive bleeding and life-threatening complications as the pregnancy advances. An early and accurate diagnosis and termination constitute pivotal points in the management. In this report, we present a patient with cesarean scar ectopic pregnancy who was unsuccessfully treated with dilatation and curettage after two-dose systemic methotrexate administration and required subsequent surgical interventions.