Objective — to improve the reproductive health of women with a post-cesarean section incompetent uterine scar at the stage of pregnancy planning, by optimizing diagnosis and management tactics. Subject and methods. Forty-five patients with an incompetent uterine scar detected at the stage of pregnancy planning were examined one year or more following cesarean section. A complicated postoperative period was common in the patients with an incompetent uterine scar diagnosed in the late period after cesarean section. Ultrasound study was a basic diagnostic method for an incompetent uterine scar. The echographic signs of partial uterine scar incompetence were an indication for hydrosonography and office hysteroscopy. Results. There were ultrasound signs of a competent uterine scar following cesarean section, absolute echographic signs of an incompetent uterine scar, and signs of its partial incompetence. When planning the next pregnancy in patients with an incompetent uterine scar, it is expedient to perform organ-sparing surgery — metroplasty followed by evaluation of scar competence after this operation. Conclusion. The authors have elaborated an examination algorithm that could choose the optimal management tactics for patients with a post-cesarean section uterine scar at the stage of planning the next pregnancy. The authors declare no conflicts of interest.