To investigate the role of endovascular treatment in the management of placenta accreta spectrum (PAS) and to review the intraoperative planning and multidisciplinary team workflow This retrospective study was performed at our institution from September 2018 to July 2020 and involved a total of thirteen women prenatally diagnosed with abnormal placentation. The patients were placed in dorsal lithotomy position for urology team to insert ureteric stents. Arterial sheath was then inserted into either the radial or common femoral artery (CFA) by vascular interventional radiology (VIR) team. The neonate was then delivered immediately via hysterotomy (CS) followed by clamping of umbilical cord. In resuscitative endovascular balloon occlusion of the aorta (REBOA) cases, the catheter was inserted by the trauma team into zone III and the balloon was inflated in order to achieve bleeding control prior to embolization (UAE) and hysterectomy. Patients were transferred afterward to the intensive care unit (ICU). The radiation dose and fluoroscopy time were recorded. The estimated blood loss (EBL), operative time, hysterectomy, postoperative complications, VIR data, maternal and fetal death, and postoperative hospitalization were recorded. Hysterectomy was required in all patients with PAS. The mean operating time, radiation dose and fluoroscopy time were 328.2 min, 4374.1 mGy and 27.7 min, respectively. The median (EBL) was 3000 mL. REBOA was placed prophylactically in 3 cases. 11 cases required embolization. Gelfoam was used as the only embolization material in 5 cases. Additional embolization material was required in 6 patients. Right radial (2 cases), left radial (6) and right common femoral (5) arteries were used as an access without any reported complications. No maternal mortality was reported. Massive blood transfusion was required in 5 cases. One woman developed respiratory distress after massive transfusion and required extracorporeal membrane oxygenation (ECMO). Hysterectomy was complicated by urinary bladder injury in 10 patients. Average hospital stays postoperatively including ICU stay was 7 days. A total of 3 fetal demise were reported. This case series delineates the important role of UAE in controlling PAS related bleeding. We believe that best results can be achieved with a multidisciplinary planning with early radiological consultation. This preliminary result should stimulate other studies to demonstrate the efficacy and safety of UAE and REBOA procedures and to best identify patients who will benefit from this approach.