To describe a modified surgical approach in the form of stepwise cesarean section in placenta percreta. We conducted a prospective observational study. A total of 71 patients with placenta percreta were subjected to the new stepwise surgical approach and uterine repair at the time of cesarean delivery. The procedure was successful in controlling the bleeding and preserving the patient's uterus in 65 (91.5%) women. Ten patients (14.1%) had urinary tract complications, nine (90%) were managed during cesarean section and one presented late in the form of vesicouterine fistula. A stepwise cesarean section is safe and effective procedure that can be applied in placenta percreta.