Caeserean scar ectopic pregnancy (CSEP) is the rarest form of ectopic pregnancy with incidence of 1 in 2000 pregnancies. It requires high degree of suspicion and if not diagnosed and managed early, can result in maternal morbidity and mortality. Due to rise in rate of caesarean sections worldwide, therehas resulted anincrease in rate of caesarean scar ectopic pregnancies. Widespread availability of ultrasound services has helped in early diagnosis and timely management. Here we present 10 cases of Caesarean scar ectopic pregnancies that we have managed over period of 5 years (2018- 2023) in our tertiary care hospital. All cases were diagnosed by either transvaginal scan or transabdominal scan done at our hospital or done outside and then referred to us for management. There are different management options for caesarean scar ectopic pregnancy ranging from conservative to surgical treatment. Medical therapy is by using Inj Methotrexate 1mg /kg body weight intramuscular. Surgical treatment includes ultrasound guided suction evacuation, laparotomy, or laparoscopic excision of scar ectopic. Since the entity is rare, presentations vary, there is no fixed protocol of management of this condition. Patient may be benefited by surgery or sometimes medical management or there may be a combination of medical and surgical management. Traditionally laparotomy was done for removal of scar ectopic, however with advent of good ultrasound machines, wecould manage most cases using ultrasound guided suction evacuation alone. Very few cases required medical management and laparotomyhad to be done in two cases.