Abstract: Objective Comparison the cure effecting of hysteroscopic curettage combined with bilateral uterine artery embolization (UAE) and uterine curettage under hysteroscopy combined with methotrexate (MTX) on cesarean scar pregnancy (CSP) treatment.Methods A retrospective analysis was used to analysis the clinical data of patients with scar uterus in our hospital from August 2014 to May 2016. According to the way of treatment, they were divided into hysteroscopic curettage + UAE group and hysteroscopic curettage + MTX intramuscular injection group. The serum HCG negative, scar lumps disappeared and menstrual recovery time were compared between the two groups during hospitalization.Results Compared with hysteroscopic curettage + MTX intramuscular injection group, hysteroscopic curettage + UAE group had shorter operation time, less intraoperative bleeding, shorter HCG conversion time, shorter hospitalized time, more hospitalized expenses. And the difference in menstrual recovery time, the incidence rate of uterine perforation, vaginal bleeding and lower abdominal pain were not statistically significant between the two groups. There was no significant difference between the two groups of patients in quality of life scores before treatment; after treatment, the quality of life scores in hysteroscopic curettage + UAE group was higher than that of hysteroscopic curettage + MTX intramuscular injection group.Conclusion Hysteroscopic curettage combined with bilateral uterine artery embolization had better therapeutic effect in the treatment of cesarean scar uterus, the symptoms and signs of recovery time were short, this method is value for clinical application.