A 35-year-old woman, G3P1A1 was diagnosed cesarean scar pregnancy by ultrasound. We performed methotrexate treatment. It was offered expectant management comprising weekly measurements of serum beta-human chorionic gonadotrophin (β-hCG) levels and serial ultrasonographic studies. β-hCG level was negative in 40 days. In the absence of randomized trials, the modality of treatment in cesarean scar pregnancy cases should be chosen on the basis of gestational age, presence of fetal heart rate, myometrial integrity, and severity of symptoms, serum β-hCG levels, the experience of the surgeon and the preference of the patient. Methotrexate injection is safe, simple and short treatment modality in hemodinamically stable case. Consequently, as a result of increasing rate of births by cesarean section uterine scar pregnancies are seen more frequently in recent years. Conservative treatment with methotrexate in these form of ectopic pregnancy is an effective and successful method. Copyright © 2012 by Türkiye Klinikleri.