Objective To evaluate the efficacy, safeness and cost of ultrasound-guided local lauromacrogol injection(USG-LLI) combined with curettage and hysteroscopy for cesarean scar pregnancy(CSP) . Design A retrospective analysis. Setting Gynaecological department in 3 hospitals in China. Population Patients with stable cesarean scar pregnancy(CSP) . Main outcome measures Efficacy and cost difference between patients with CSP pretreated by different methods combined with curettage and hysteroscopy. Methods From June 2018 to December 2019 and included 151 CSP patients were diagnosed with CSP, and treated by USG-LLI or uterine artery embolization (UAE) combined with curettage and hysteroscopy. Clinical data and outcome were analysed. Results There were no significant differences in basic clinical characteristics in the two groups. The success rates of the two groups were similar, while the complication rates (5.81%, 24.62%) of USG-LLI group and UAE group were different significantly. The total cost between the two groups and found a statistical difference between the two groups, which was higher in the UAE group (P < 0.05). The non-medication cost and direct medical cost of the UAE group were higher than those in USG-LLI group (P < 0.05) . Conclusions The method of USG-LLI combined curettage and hysteroscopy was minimally invasion and efficiency for CSP, compared with curettage after UAE. USG-LLI resulted in lower complication rate and little expense.