Objective To investigate the safety and efficacy of abdominal aortic balloon occlusion versus uterine artery embolization（UAE） as the pretreatment for cesarean scar pregnancy（CSP）. Methods A retrospective analysis was performed for 104 patients with CSP who were admitted to Chengdu Women and Children's Central Hospital from January 2018 to December 2019 and were diagnosed based on clinical and radiological examinations，among whom 47 received abdominal aortic balloon occlusion before surgery and 57 received UAE before surgery. Results There were no significant differences in general information and treatment outcome between the two groups（P>0.05）. There were significant differences between the two groups in hospital costs，pain after interventional surgery，duration of interventional radiation and body surface radiation dose under X-ray fluoroscopy，and postoperative menstrual changes（P<0.05）. Conclusion Both abdominal aortic balloon occlusion and UAE can effectively control intraoperative bleeding as the pretreatment for CSP，and compared with UAE，abdominal aortic balloon occlusion significantly reduces the duration and dose of radiation for both medical staff and patients，with no severe pelvic pain and a few postoperative complications such as the reduction in menstrual volume and amenorrhea. Abdominal aortic balloon occlusion has no near-term effect on uterine and ovarian function，but with a relatively high price.