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Background: Caesarean scar ectopic pregnancy (CSEP) is a rare form of ectopic pregnancy where implantation occurs within the myometrium of a previous caesarean section scar. With rising caesarean delivery rates and enhanced imaging techniques, its incidence is increasingly recognized. Objective: To highlight the importance of early diagnosis and appropriate management strategies in minimizing complications associated with CSEP. Methods: A review of CSEP cases was conducted, focusing on clinical presentation, diagnostic approaches, and treatment options. Transvaginal ultrasonography (TVUS) was emphasized as the diagnostic modality of choice due to its accuracy in identifying the gestational sac within the caesarean scar. Results: Clinical presentations ranged from asymptomatic to symptoms like vaginal bleeding and pelvic pain. Key ultrasound features included an empty uterine cavity, a gestational sac at the level of the scar, and thin myometrial tissue separating the sac from the bladder. Management strategies included medical therapy (methotrexate), surgical removal, and minimally invasive techniques tailored to gestational age and patient stability. Conclusion: CSEP is a high-risk condition requiring prompt recognition and individualized treatment. Awareness among clinicians and early intervention are critical to prevent life-threatening complications such as uterine rupture and hemorrhage while preserving fertility.