Design: Case series

Setting: operating room, patients under spinal anesthesia, using a standard oval 05 mm hysteroscope with 05 French scissors and 05 French needle with 02 cc of KCL.

Patients or Participants: 21 CSP cases, with a gestational age of 08 weeks or less

Interventions: Hysteroscopic intra-gestational sac KCL injection, under spinal anesthesia. follow up for three months post procedure.

Measurements and Main Results: patients aged between 26 and 41 years and a history of 01 to 04 previous cesarean sections. In all 21 patients the procedure was successfully completed. Complication included one uterine wall rupture requiring laparoscopic repair and one patient with post procedure bleeding that spontaneously resolved. KCL injection achieved success in 19 out of 21 cases, with no correlation between the number of cesarean scars and CSP incidence. No late complications were observed post-second procedure.

Conclusion: Hysteroscopic KCL intra-gestational sac injection represents a viable technique for managing selected cases of CSP. Despite potential complications, it offers a less invasive alternative that could be considered as a therapeutic option,