A 30-year-old woman, gravida 3 para 1, presented at 5 weeks of amenorrhoea with vaginal spotting and mild abdominal pain. A transvaginal scan confirmed a caesarean scar pregnancy (CSP). Serum hCG level at presentation was 4357. She declined treatment initially, but eventually underwent laparoscopic-guided suction curettage and excision of CSP. hCG was undetectable at 5 weeks postoperatively. She had an uneventful recovery and was advised to take oral contraceptives.