Pregnancy with uterine scar diverticulum can be done under doctor’s supervision for shallow and small diverticulum, but when the diverticulum is large in size, it needs to be treated before pregnancy. Uterine scar diverticulum is caused by poor anatomical alignment of the uterine incision during the healing process. When ultrasound testing suggests that there is a uterine scar diverticulum, the size and depth of the diverticulum will also be used to determine whether pregnancy is possible. For shallow and small diverticula, pregnancy can be attempted and closely monitored. For larger diverticula, surgical treatment is required before pregnancy can be carried out. For women with combined uterine keloid diverticula, the position of the gestational sac in relation to the keloid diverticulum should be monitored in early pregnancy to rule out the possibility of a keloid pregnancy. In late pregnancy, as the fetus grows, the uterine tension will increase. It is important to closely monitor the localized thickness of the myometrium in the lower segment of the uterus and terminate the pregnancy at the right time to avoid uterine rupture to ensure the safety of the mother and baby. Whether pregnancy is possible with uterine scar diverticulum should be specifically consulted with professional medical advice.