【Abstract】Objective To observe the efficacy and safety of uterine artery embolization (UAE) combined with laparoscopic lesion excision in the treatment of cesarean scar pregnancy (CSP). Methods The clinical data of 80 CSP patients treated in our hospital from January 2014 to December 2019 were retrospectively analyzed, and the patients were grouped according to the treatment methods, including 39 cases in control group (laparoscopic lesion excision) and 41 cases in observation group (UAE+laparoscopic lesion excision). The clinical efficacy, perioperative indicators ［operative time, intraoperative blood loss, postoperative vaginal bleeding time, hospital stay］, and blood flow parameters ［vascularization index (VI), blood Flow pulsation index (PI), resistance index (RI), blood flow index (FI)］, ovarian function ［follicle stimulating hormone (FSH), estradiol (E2), anti-müllerian hormone (AMH), luteinizing hormone (LH)］ and recovery times of disease-related indicators ［negative conversion time of serum human chorionic gonadotropin (β-hGG), disappearance time of abnormal uterine masses, menstruation recovery time］ before surgery and at 3 months after surgery were compared between the two groups, and the occurrence of postoperative complications were used to evaluate the safety of treatment. Results The operative time, intraoperative blood loss, postoperative vaginal bleeding time, and hospital stay in observation group were significantly lower than those in control group (P＜0.05). At 3 months after surgery, the VI levels of the two groups were significantly lower than those before surgery (P＜0.05), and the level in observation group was significantly lower than that in control group (P＜0.05), and there were no statistically significant differences in the PI, RI, and FI levels between the two groups (P＞0.05). At 3 months after surgery, there were no significant differences in the levels of FSH, E2, AMH, and LH in the two groups compared with those before surgery (P＞0.05), and there were no statistically significant differences between the two groups after surgery (P＞0.05). There were no statistically significant differences in the negative conversion time of β-hGG, disappearance time of abnormal uterine masses andmenstruationrecovery time between the two groups (P＞0.05). There were no statistically significant differences in the incidence rates of postoperative complications such as nausea and vomiting, leukopenia, abdominal pain, fever, and pelvic infection between the two groups (all P＞0.05). Conclusion UAE combined with laparoscopic lesion excision and laparoscopic surgery can effectively improve the serum β-hGG level in patients with CSP, and are beneficial to the disappearance of abnormal uterine masses and the recovery of menstrual cycles, and have no significant effect on ovarian function. And the two are similar in terms of complications, but the combination of UAE can significantly reduce the operative time, intraoperative blood loss, postoperative vaginal bleeding time, and hospital stay.