Abstract: Objective To compare the therapeutic efficacy among the combined laparoscopy and hysteroscopy,vaginal surgery and hysteroscopic surgery for post-caesarean section uterine scar defects (PCSD). Methods The patients received combined laparoscopy and hysteroscopy,vaginal surgery and hysteroscopic surgery in in Huzhou central hospital and Taizhou hospital of Zhejiang province from January,2010 to December,2015 were enrolled and divided into group A,B and C with 35 cases in each group.The operation,treatment expenses,duration of hospital stay,therapeutic effect,postoperative menstruation and pregnancy were compared among the three groups. Results The operative time,blood loss in group A were higher than those of group B and group C (P<0.05),the operative time,blood loss of group B were higher than those of group C (P<0.05);the postoperative bleeding of group A and B group were higher than that of group C (P<0.05).The treatment cost more group A than group B and group C (P<0.05).The group B cost less than group C (P<0.05);the hospitalization time of group B was longer than that of group A and group C (P<0.05),the hospital stay of group A was longer than that of group C (P<0.05).The differences of efficacy among the three groups were statistically significant (P<0.05),the excellent rate of group A was significantly:higher than group C (P<0.05).The postoperative menstruation normal rate of group A and group B were higher than that of group C (P<0.05),the rate of menstruation recovery after the operation between group A and B group was no significant difference (P>0.05);the postoperative pregnancy rate among the three groups was no statistically significant (P>0.05). Conclusion The combined laparoscopy and hysteroscopy,vaginal surgery and hysteroscopic surgery are all the effective method for PCSD,with its own characteristics.A comprehensive consideration is need when the surgical planning is selected.