
Background: Placenta previa accreta is a morbidly attached placenta villi to the uterine wall with absence of the decidua basalis. Objective: to evaluate the diagnostic value of sonographic criteria in placenta accreta and to develop screening tools for antenatal evaluation. Patient and Methods: sixty pregnant women beyond 28 weeks of gestation having placenta previa in their current pregnancies underwent obstetrical ultrasound & gray-scale and Doppler sonographic criteria for the diagnosis of placenta accreta were recorded, all cases were followed up until end of pregnancy & the final diagnosis was confirmed by surgical and histopathological reports. Results: Disruption of the placental–uterine wall interface and the presence of vessels crossing these sites were the only two high significant individual criteria that could distinguish placenta accreta from non-accreta Conclusion: Color doppler ultrasonography had a higher overall accuracy (95%), in diagnosis of placenta accreta compared to lower but still valuable gray scale ultrasonography (90%).