<p>Background: Cesarean section scar ectopic pregnancy (CSEP) is a rare and poten-tially life-threatening condition. A standardized management protocol is yet to be established owing to limited data available.<br /> Case Presentation: In this paper, five cases of CSEP over a period of 18 months at a tertiary referral hospital, managed medically with methotrexate administered both systemically and into the gestational sac at the time of feticide with potassium chloride (KCL) are presented. Surgical management was the second line therapy when medical treatment failed.<br /> Conclusion: With rising trends in cesarean deliveries, CSEP may be a challenge which requires close investigation regarding its diagnosis and treatment on the merits of case studies and available healthcare facilities.</p>