Implantation of a pregnancy within a cesarean fibrous tissue scar is considered to be the rarest form of ectopic pregnancy and a life-threatening condition. This is because of the very high risk for uterine rupture and all the maternal complications related to it. The diagnosis and treatment of cesarean scar pregnancy (CSP) is challenging. This chapter covers the epidemiology, diagnosis, magnetic resonance imaging, management, combined medical treatment, differential diagnosis, and complications. The diagnosis and treatment of cesarean scar pregnancy (CSP) is challenging. Transvaginal sonography and color Doppler ultrasound are the best diagnostic tools for its detection, and if needed, for treatment as well. A low, anteriorly displaced gestational sac in a pregnancy with a history of previous cesarean delivery is almost certainly a CSP.