Abstract: ob＜x＞jective To explore the therapeutic effect of hysteroscopic diverticulum intima removal combined with laparoscopic scar defect reinforcement on cesarean scar diverticulum.Methods 60 cases of cicatricial diverticulum of cesarean section diagnosed in our hospital were analyzed retrospectively.Follow-up visits were performed 1,3,6 and 12 months after surgery and then annually. One month after operation, the patients were followed up for the healing of the incision. The menstrual cycle was measured three months, six months and 12 months after operation. The thickness of the thinnest myometrium and the volume of uterine diverticulum were measured at 3, 6 and 12 months after operation. Cases of intrauterine pregnancy followed up 24 months after operation. Results There were no complications in 60 follow-up patients. Of 60 women, 51 (85%, 51/60) women were cured; 9 (15%, 9/60) cases were invalid; 3(5%, 3/60) cases recurred. The median menstrual period of 3 months, 6 months and 12 months after operation was 8.1 days (4.00-18.00 days), 8.2 days (4.00-20.00 days) and 8.5 days (5.00-20.00 days), which was significantly shorter than that before operation (P < 0.05). The median volume of cesarean scar diverticulum was 0.42 cm3 (0.04-14.40 cm3), 0.37 cm3 (0.06-3.84 cm3), 0.54 cm3 (0.101-4.61 cm3), which was significantly smaller than that before treatment (P < 0.05). The median thickness from the bottom of the scar diverticulum to the thinnest sarcoplasmic la＜x＞yer was 0.25cm (0.15-0.50cm), 0.25cm (0.15-0.50cm), 0.24cm (0.15-0.50cm), which was larger than that before treatment (P < 0.05).Conclusions Hysteroscopic diverticulum intima removal combined with laparoscopic scar reinforcement for cesarean scar diverticulum surgery can not only alleviate the menstrual condition of diverticulum patients, but also effectively repair the isthmus anatomy, and do not damage the continuity of myometrium tissue in diverticulum, increase myometrium thickness, and reduce the risk of uterine rupture in the second pregnancy.