This comprehensive educational lecture discusses the diagnosis and surgical management of cesarean scar ectopic pregnancy using current evidence and real operative footage. It explains the imaging criteria for diagnosis, differentiates scar ectopic pregnancy from other similar conditions, and introduces a modern classification based on residual myometrial thickness. A detailed laparoscopic procedure demonstrates safe bladder dissection, excision of the ectopic pregnancy, removal of scar tissue, and myometrial reconstruction. The presentation also covers hysteroscopic management of selected cases and provides an evidence-based approach to treating isthmocele (niche). The concluding treatment algorithm helps surgeons select the most appropriate management based on fertility goals and uterine wall thickness.