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To review systematically the medical literature reporting on the prevalence of a niche at the site of a Cesarean section (CS) scar using various diagnostic methods, on potential risk factors for the development of a niche and on niche‐related gynecological symptoms in non‐pregnant women.

The PubMed and EMBASE databases were searched. All types of clinical study reporting on the prevalence, risk factors and/or symptoms of a niche in non‐pregnant women with a history of CS were included, apart from case reports and case series.

Twenty‐one papers were selected for inclusion in the review. A wide range in the prevalence of a niche was found. Using contrast‐enhanced sonohysterography in a random population of women with a history of CS, the prevalence was found to vary between 56% and 84%. Nine studies reported on risk factors and each study evaluated different …