To report a cesarean scar pregnancy (CSP) with a coexistent viable intrauterine pregnancy.Case report.Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou, Taiwan.A 31-year-old woman, with previous cesarean delivery, presented with vaginal bleeding, was transferred to our hospital at 7 weeks' gestation for heterotopic pregnancy after an IVF–embryo transfer. A diagnosis of intrauterine pregnancy combined with CSP was made by ultrasonography.Hysteroscopic-directed evacuation of CSP.Good hemostasis at cesarean site and ongoing intrauterine pregnancy.A healthy baby was delivered by cesarean delivery at term.With the increasing number of IVF–embryo transfers, the amount of heterotopic pregnancies is also increasing. Hysteroscopic management of CSP is a minimally invasive procedure that leads to successful obstetric outcomes in the corresponding intrauterine pregnancies.