Cesarean scar pregnancy (CSP) is a rare disease. Because of the serious consequences of the disease, early diagnosis and treatment are very important. Furthermore, the diagnosis is difficult and the standard treatment is still unknown. We reported a rare case of 33-year-old woman, Para 2-0-0-2 with cesarean section of prior two pregnancies, presented with abnormal vaginal bleeding for 2 months. The uterus was slightly enlarged but otherwise unremarkable. Urine pregnancy test was positive. Gestational age was about 8 weeks from the last periods. Transvaginal ultrasonography revealed heteroechoic mass size 4.89 x 3.99 x 5.42 cm at anterior lower uterine segment occupied the hold thickness of the myometrium, adjacent to the uterine serosa. These findings were compatible with a cesarean scar pregnancy. After counseling regarding treatment options, the patient and her family could not accept risks for uterine preserving treatment and subsequence pregnancy complications and thus chose definitive surgery, hysterectomy. After surgery, no complication was observed. Therefore, hysterectomy is an alternative option for cesarean scar pregnancy treatment who could not take the risk of uterine preserving treatment.