The aim of this study was to provide a representative description of abnormal placental implantation images in 2D ultrasound and color Doppler, 3D multiplanar technique and magnetic resonance imaging, and to correlate this with intrasurgical images. Placenta accreta occurs 10% of women with placenta previa. The risk of placenta accreta is increased by previous Cesarean section. We present 15 cases (diagnosed between 2003 and March 2007) with placenta increta and percreta diagnosed prenatally by 2D ultrasound, color Doppler, 3D multiplanar technique (vascular mapping) and MRI. Imaging findings were correlated with intrasurgical findings. Of the 15 cases with a diagnosis of placenta increta and percreta, only one had a posterior implantation; the other 14 cases had an anterior and uterine segment implantation. The diagnosis was prenatal in 14/15 cases and in one case the diagnosis was intrasurgical. The median gestational age at diagnosis was 28 weeks. The median gestational age at delivery was 35 weeks. All cases were confirmed at operation and needed Cesarean–hysterectomy. When we used the ultrasound signs (on 2D ultrasound, color Doppler, 3D multiplanar technique) placenta lacunae, bladder border, myometrial thickness and loss of the clear space, the diagnosis was better evaluated with 3D multiplanar technique. In eight cases the MRI was reported as normal. We conclude that the principal signs of placenta increta and percreta were loss of the clear space and the superficial vessels. These ultrasound markers and mapping of the vascular pattern were better evaluated in the 3D multiplanar technique; this technique allows an adequate and sufficient evaluation of all areas of placental implantation. It also provides better information for the surgical team than MRI. These findings should allow appropriate resources to be made available at delivery in order to minimize the complication rate.