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INTRODUCTION: Scar ectopic pregnancy was first reported in 1978. It poses a diagnostic and management challenge and leads to considerable maternal morbidity and mortality. CASE REPORT: A 29 year old G2P1L1 with one previous caesarean section presented to the labour ward with spotting per vagina. The ultrasound report showed a viable caesarean scar ectopic pregnancy of 6 weeks and 3 days gestational age. She was treated conservatively with potassium chloride and methotrexate. She was followed up weekly with ultrasonography and Beta hcg levels. DISCUSSION: Sonographic criteria of caesarean scar ectopic should be present. The accuracy rate of transvaginal colour doppler is 82%.The aim of management is to decrease life threatening complications and unnecessary hysterectomy. CONCLUSION: Caesarean scar pregnancy is one of the rarest but most dangerous among ectopic pregnancies. It is associated with catastrophic life threatening complications. It is also a diagnostic challenge. The above case was managed conservatively with good outcome.