Cesarean section (CS) is among the most common surgical interventions in obstetrics worldwide, with increasing prevalence due to rising maternal age and obstetric complications. While generally safe, CS carries long-term complications, notably uterine scar deficiency, also known as isthmocele or niche defect. Uterine scar deficiency is characterized by a thinning or dehiscence of the myometrium at the CS site, which may result in abnormal uterine bleeding, chronic pelvic pain, dysmenorrhea, infertility, and increased risks in subsequent pregnancies, including placenta previa and uterine rupture. In Surkhandarya region, Uzbekistan, the prevalence and clinical outcomes of uterine scar deficiency remain poorly documented, with only limited case reports and small-scale studies available.