We consider stochastic differential equations with (oblique) reflection in a $2$-dimensional domain that has a cusp at the origin, i..e. in a neighborhood of the origin has the form $\{(x_1,x_2):0<x_1\leqδ_0,ψ_1(x_1)<x_2<ψ_ 2(x_1)\}$, with $ψ_1(0)=ψ_2(0)=0$, $ψ_1'(0)=ψ_2'(0)=0$. Given a vector field $γ$ of directions of reflection at the boundary points other than the origin, defining directions of reflection at the origin $γ^i(0):=\lim_{x_1\rightarrow 0^{+}}γ(x_1,ψ_i(x_1))$, $ i=1,2,$ and assuming there exists a vector $e^{*}$ such that $\langle e^{*},γ^i(0)\rangle >0$, $i=1,2$, and $e^{*}_1>0$, we prove weak existence and uniqueness of the solution starting at the origin and strong existence and uniqueness starting away from the origin. Our proof uses a new scaling result and a coupling argument.