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Placenta Accreta Spectrum (PAS) disease is a rare disorder but not so rare in a tertiary care centre where 42 patients were managed in the time period, from 1st December, 2023 t0 30th November, 2024, in the department of Obstetrics and Gynaecology, Lok Nayak Hospital, MAMC, New Delhi. Majority of the patients were referred while around a third diagnosed in centre?s booked patients too. Sonography was the main tool of diagnosis but MRI aided in certain increta patients and most of the percreta patients. Multidisciplinary approach, multiple blood/products transfusions, emergency/elective hysterectomies, ICU admissions, prolonged hospital stays and post-operative morbidities were the common features whereas a few patients were managed with uterine conserving surgeries, uterine artery embolization and uterine devascularization too. Few neonatal demises and even some neonatal morbidities were noted but no maternal mortality occurred with PAS in this centre in this time period.