( Acta Obstet Gynecol Scand . 2021;100:1445–1453) Placenta accreta spectrum (PAS) often causes massive bleeding and has a mortality as high as 7%. While specific factors related to risk for maternal deaths due to PAS have not been sufficiently identified, few reports describe the contribution of inexperienced surgeons, underestimation of blood loss, and delays in transfusions. Although publications recommend that women affected by PAS receive attention in hospitals with teams trained in treatment of PAS, it is difficult to identify this type of hospital in low- and middle-income countries (LMICs). Even hospitals with personnel from multiple specialties may not ensure favorable outcomes as few are trained in the specific diagnosis and surgical treatment of PAS and inexperience is identified as a frequent contributing factor to maternal deaths associated with PAS. This report investigated PAS-associated causes of maternal death and challenges related to diagnosis and treatment.