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Isthmocoele is an indentation at the caesarean scar caused by inadequate myometrial healing, leading to symptoms such as abnormal uterine bleeding, pelvic pain and secondary infertility. It appears as a hypoechoic collection at the scar site on transvaginal ultrasound, often with a residual myometrial thickness (RMT) <3 mm. We present a case of a woman in the late 30s, who is a multipara with three prior caesarean sections. She presented with a 2-year history of irregular prolonged intermenstrual bleeding and pelvic pain. Transvaginal sonography revealed a 1.2×1.5 cm niche with RMT of 2.8 mm. As medical therapy failed, she underwent successful laparoscopic isthmocoele repair with complete symptom resolution. A follow-up imaging confirmed restoration of normal uterine anatomy. This case highlights the efficacy of laparoscopic repair in managing symptomatic isthmocoele with thin residual myometrium.