Management of placenta accreta has been described as one that should be multidisciplinary involving an obstetrician, interventional radiology, neonatologist, anesthesia service and the creation of protocols for management has been described at different centers with improved outcomes [7]. AbstractIntroduction: The reported incidence of placenta accreta has increased 10 fold. Cesarean section has been described as one of the most prevalent risk factors. In 2012, the CDC reported a C-section rate of 48.5% in Puerto Rico (PR). Placenta accreta has been implicated to increase morbidity/mortality in the maternal population as well as to the fetus. The objective of the current study is to describe the population and outcomes of Puerto Rican women diagnosed with abnormal placentation in a tertiary hospital in Puerto Rico. Methodology:We performed a retrospective descriptive study of medical records identified with an abnormal placentation from 2009-2015. The records were obtained from the record room of the University District Hospital of Centro Medico of PR. Data regarding patient demographics, risk factors, maternal and fetal outcomes were recorded using EPI INFO statistical software.Results: A total of 20 medical records were analyzed. The mean maternal age was 31 years, mean gravity 3.8 and mean gestational age at delivery was 28 weeks. All but one had previous cesarean sections and 1 patient had more than 4 previous cesarean sections. Mean neonatal weight was of 2417g. 11 patients had an estimated blood loss of more than 2L and 10 patients received postoperative blood transfusions. 11 bladder injuries were reported and 17 patients had cesarean hysterectomies performed. Conclusion:We emphasize the importance of evaluating risk factors and recommend management of suspected cases of abnormal placentation to be done in an interdisciplinary manner and in settingwhere immediate access to blood transfusions is available.