Horn pregnancy is a type of ectopic pregnancy with a low incidence, but it is prone to rupture of the uterine horn during pregnancy, resulting in life-threatening hemorrhagic shock. Because of the difficulty and risk of scraping the uterus and the tendency of leakage of aspiration, the treatment of horn of uterus pregnancies used to be mostly cesarean surgery to remove the horn of uterus and the fallopian tube on the affected side. With the improvement of clinical endoscopic techniques and ultrasound, there are various methods for the treatment of horn pregnancy. We applied hysteroscopy combined with ultrasound to the treatment of horn pregnancy, which showed good clinical results, and all cases were successfully completed without complications. In the hysteroscopic surgery group, 11 cases were treated with aspiration plus hysteroscopy or mechanical scraping with hysteroscopic electric ring, all of which were cleared in one go. 15 cases were treated with hysteroscopic bipolar vaporization or hysteroscopic electric cutting, all of which were cleared in one go. Because of the special implantation site, horn pregnancy is prone to miscarriage in early pregnancy and horn rupture in mid pregnancy. Therefore, early detection and timely termination of pregnancy are advocated. Hysteroscopic treatment of horn pregnancy is a new type of procedure. The authors appreciate that it is only suitable for the unruptured type of horn pregnancy. If the horn of the uterus is ruptured and cannot be dilated, hysteroscopic surgery cannot be performed. Moreover, the gestational week of horn pregnancy should not be greater than 10 weeks. Hysteroscopic treatment of horn pregnancy is a more desirable surgical procedure. Hysteroscopic treatment of horn pregnancy preserves the anatomical integrity of the uterine horn and the integrity of the fallopian tubes, avoiding the trauma of open surgery. In recent years, with the maturation of laparoscopic technology, laparoscopic hysterectomy is also feasible instead of traditional open surgery. However, both laparoscopic and open surgery have the same problems of trauma, loss of one horn of the uterus, obstruction of the fallopian tube, change of uterine morphology, uterine scarring, pelvic adhesions, etc. The impact on re-pregnancy can be imagined, and even if re-pregnancy is possible, 2 years of contraception is needed. Therefore, for unruptured horn pregnancy, the authors recommend hysteroscopic surgery as the first option. However, it is important to remember that all hysteroscopic procedures for horn pregnancy should be prepared for immediate intermediate open or laparoscopic surgery and should not be done blindly.