Objective To explore the value of transvaginal ultrasound in the early re-pregnancy of cesarean scar uterine. Methods 1870 first trimester re-pregnancy women underwent transvaginal ultrasound examination in our hospital with a history of cesarean section from January 2015 to December 2017 were included in the present study. The value of transvaginal ultrasound in early repregnancy of cesarean scar uterine were evaluated with the pregnancy outcome and clinicopathology.Results 37 scar pregnancy were diagnosed by clinical pathology. Ultrasound diagnosis of scar pregnancy was correct in 31 cases（83.8%）， misdiagnosis in 4 cases（10.8%） and missed diagnosis in 2 cases（5.4%）. Scar pregnancies included type of pregnancy sac in the muscle layer at the scar (16 cases), type of pregnancy sac in the scar and uterine cavity (7 cases) and type of block (8 cases). The area under the curve of transvaginal ultrasound diagnosis of scar pregnancy was 0.918. The sensitivity and specificity were 0.838 and 0.998. Conclusion Transvaginal ultrasound can clearly show the relationship between the gestational sac and the scar of the uterus. It has a good application value for the early diagnosis of uterine scar pregnancy.