Cesarean scar pregnancy (CSP) is defined as an implantation of pregnancy in a fibrous tissue scar of a previous cesarean section. It is considered as one of the rarest forms of ectopic pregnancy and can be life threatening. The incidence of CSP is steadily rising in view of increasing cesarean section rates. A very high index of clinical suspicion is required for the diagnosis and further management. Through this case report, we demonstrate the laparoscopic management of a previous failed methotrexate (MTX) therapy in a CSP.