Background: Management of cesarean scar pregnancy (CSP) is challenging as there are no specific treatment guidelines and management ought to be individualized. Aim: This study aims to analyze the various treatment modalities done for CSP. Materials and methods: This single-center retrospective study was done between 2017 and 2021 in a tertiary care hospital in South India. Data of all patients with a diagnosis of CSP between 2017 and 2021 were taken from the hospital database, and the cases were analyzed. The patients were divided into the following two groups based on gestational age at diagnosis: Group I, below 8 weeks at diagnosis and group II more than 8 weeks at diagnosis. Statistical analysis was performed, and the results were analyzed and compared between the two groups using Fisher's exact test for categorical variables and analysis of variance (ANOVA) for continuous variables, and p-value significance was considered as below 0.05. Results: During the 5-year period, there were a total of 23 cases of CSP. The mean age of the women in the study was 30.8 years; 14 belonged to group I and 9 women were in group II; 2.60% had vaginal bleeding; and 30.4% were asymptomatic. Transvaginal ultrasound is used as a diagnostic modality. Most of our patients had combined treatment modalities. Systemic methotrexate (MTX) or uterine artery embolization (UAE) was done prior to the procedure which was followed by either suction and evacuation or excision of scar pregnancy by laparotomy. Suction and evacuation under ultrasound guidance were performed on 12 of 14 patients in group I. The procedure was uneventful in all patients, without any complications during the procedure or post-procedure. There was no significant blood loss requiring a blood transfusion. In group II, laparotomy with excision of scar pregnancy was done in seven out of nine patients. Among them, in two patients suction and evacuation was done initially and proceeded to laparotomy because of increased bleeding. Patients were followed up with day 7 beta-human chorionic gonadotropin (β-HCG). Mean pre- and posttreatment β-HCG levels were calculated. The percentage decrease in β-HCG in group I was 87.66% and in group II was 80.56%. Conclusion: Early diagnosis is very important not only in catastrophic in reducing complications but also in successful management. Patients with early gestational age can be managed successfully with suction and evacuation and for those with higher gestational age and higher beta HCG level, laparotomy and scar pregnancy excision can be done.