Aim: To assess primary cesarean scar after 6 weeks post-delivery to describe its characteristics using two-dimensional transvaginal ultrasound. 
Methods: This cross-sectional study was performed at Mansoura University Hospitals, Mansoura, Egypt from the beginning of March 2020 to March 2021. Eighty women underwent primary cesarean section fulfilled the inclusion criteria were examined by TVUS to evaluate cesarean scar after 6 weeks from delivery. The main outcome was measurement of residual myometrial thickness (RMT), while the secondary outcome was niche measurement (depth, width, site, shape).  
Results: The mean age of included cases was 24.63 ± 6.23 years. The mean GA at delivery was 37.21 ± 2.50 weeks. The cephalic presentation was predominant in 68.75% of females. Maternal indications for CS were reported in 50% of females, fetal indications in 46.3%, while unreliable indications were shown in 3.7%. The mean niche depth was 1.16 ± 0.46 cm. The mean niche width was 1.48 ± 1.17 cm. The mean site (From incision to internal os) was 0.21 ± 0.43 cm. The mean RMT was 0.84 ± 0.55 cm. The mean RMT-OS was 1.8 ± 1.82 cm. Triangular shape of niche was the most common shape in 72.5% of females. Circular shape of niche was detected in 17.5 % of females, both oval shape and polygonal shape were 5 %, each. No significant differences were observed between level of experience of main surgeon, closure of visceral or parietal peritoneum & state of labor and RMT. Also, no significant difference was found between level of experience of main surgeon and site & shape of niche. 
Conclusion: Caesarean section scar in women after 6 weeks from primary CS assessed by using 2D-TVUS was not affected by the site of CS incision, surgeon's experience, visceral or parietal peritoneum closure and labor stage at the time of CS.