Objective: Study the value of early appearance of ultrasonographic findings of placenta accrete and its relation to the accuracy of diagnosis with its impact on prognosis.Methods: Prospective cohort study, by ultrasound examination of 55 women in the duration of the study (14 months) all suffering from the presence of low lying placenta with previous uterine scar between 12-20 weeks gestation. The main outcome is to predict placenta accrete and its related complications.Results: 55 cases were included. The most common sign was loss of retroperitoneal space ( 31 cases – 56%)  and focal lacuna (24 cases – 44%), they are the most sensitive early sign ( sensitivity 55.26%) , while thinning of myometrium is the least sensitive sign ( 13.16%) , while thinning myometrium , presence of diffuse lacunae and tornado sign are the most specific reaching 100% ,while loss of retroperitoneal space was the least specific ( 41.18%) ,  so the most accurate is the presence of focal lacunae (63.64%) , while thinning of the myometrium is the least accurate (40%). Conclusion: The use of ultrasound in evaluation of placenta accrete between 12-20 weeks is very beneficial and could be used with variable degrees of accuracy.