Placenta percreta is a life threatening obstetrical condition. Diagnosis is often achieved by conventional ultrasound imaging at second half of pregnancy leading to multiple and severe complications. Due to its increasing incidence, a reliable and earlier antenatal diagnosis is needed. We describe prenatal assessment, outcome and pathological anatomy of placenta percreta in three early diagnosed cases before 11 weeks with conventional two dimensional (2D) and three dimensional (3D) ultrasound and using novel techniques as DMR and 3DXI. As long as we know these are the earliest cases reported. We describe conventional 2D and 3D ultrasound imaging findings supplemented by DMR and 3DXI in three cases of first trimester diagnosed placenta percreta with the use of Accuvix XQ ultrasonographic equipment (Medison. Seoul, Korea). The obtained data were analyzed in the post-processor software 3DXI viewer (V1.00.0518, Medison, Seoul, Korea) and correlated with clinical and pathological findings. Conventional sonographic examination revealed bulging of placental tissue to uterine serosa at first trimester in patients with morbidly-adherent placenta. DMR and 3DXI confirmed previous findings and revealed the depth and extend of placental invasion into the miometrium. DMR and 3DXI are useful additional methods to diagnose and classify morbidly-adherent placenta.