Cesarean incisional pregnancy is a rare and specific type of ectopic pregnancy, which is a potential, long-term complication of cesarean delivery. Due to the weak scar tissue of the incision, poor scar healing, endometritis, poor development of the uterine metaplasm, which is not conducive to the development of the gestational sac, early miscarriage or irregular vaginal bleeding often occurs, the lack of endometrial interstitial metaplasm at the incision site, the direct invasion of trophoblast cells into the myometrium, and even cause uterine rupture. In recent years, with the increase in the number of cesarean deliveries, the incidence of incisional pregnancy is on the rise: 1:2500 to 1:20000, accounting for 0.15% of ectopic pregnancies. The early diagnosis rate of this disease is low, and it is easily misdiagnosed as intrauterine pregnancy, while traditional abortion or curettage is prone to haemorrhage, shock and even life-threatening, therefore, the diagnosis and management of this disease has always been a difficult problem in the field of obstetrics and gynecology. In recent years, the advantages of hysteroscopy in the treatment of various uterine diseases have become increasingly evident. Its indications are extremely broad, including: abnormal uterine bleeding, postmenopausal uterine bleeding, infertility, diagnosis of recurrent miscarriage, and uterine occupancy, including endometrial polyps, submucosal fibroids, uterine longitudinal septum, uterine foreign bodies including intrauterine device insertion, abortion residue, and treatment of endometrial electrosurgery. Compared with simple scraping, it has the advantages of intuitive, diagnostic and therapeutic balance, fine operation, high safety, and the advantage of stopping bleeding under direct vision, which cannot be replaced by a small operation. It provides the necessary conditions for conservative treatment, avoiding total hysterectomy and preserving the patient’s reproductive function. To summarize these cases, the following lessons were learned: 1. Adequate preoperative preparation: preoperative intervention: local injection of MTX in the lesion and injection of gelatin sponge embolization of bilateral uterine arteries can effectively reduce intraoperative bleeding; 2. Grasp the timing of post-interventional surgery, usually about 48 hours after the intervention. If the interval is too short, the uterine wall will be ischemic and edematous after arterial embolization, and perforation will be easy; if the interval is too long, the blood vessel will be reopened and bleeding will be easy. 3. use hysteroscopy with electrocoagulation of 50w; 4. use circular bipolar blunt separation to minimize the frequency of coagulation with electrodes to ensure safety. Through the practice of these difficult cases, we have accumulated valuable experience in hysteroscopic management of specific diseases, which provides another feasible, convenient, and safer route for the majority of patients and is worthy of reference and promotion.