Placenta accreta is the abnormal adherence of the placenta to the uterine wall. Where placenta accreta is present, the failure of the placenta to separate normally from the uterus after delivery is accompanied by severe postpartum hemorrhage. The best outcomes in placenta accreta are in prenatally diagnosed electively delivered cases. Management should take place in centers with special expertise. All obstetric units should have an obstetric hemorrhage protocol in place.