With increasing rates of delivery by caesarean section has come an increase in rates of associated complications, including caesarean scar defect. Whilst the management of this issue remains controversial, evidence is building for surgical management of such a defect for resolution of menstrual symptoms, pain and subfertility. We present a case report and surgical video of a hysteroscopic guided, laparoscopic excision of a caesarean scar defect. Following the successful management of this case and a literature review of the technique, we conclude this to be a safe, feasible and effective procedure with a low rate of complications.