Background: Placenta previa with and without accreta spectrum are among the most serious obstetric conditions that needs a multidisciplinary team-work to achieve best maternal outcome. We reviewed our experience over 21 years at an academic tertiary hospital before and after establishment of placenta previa team Objective: To study the experience of a single academic center managing patients with placenta previa and placenta accreta spectrum over two decades. Design: Retrospective chart review Patients and Methods: This study included all cases with a confrmed diagnosis of placenta previa and/or placenta accreta spectrum that were managed at Jeddah after King abdulaziz university Hospital from 2001 to 2021. Paper and electronic chart reviews and a search of the birth registry book were performed for all cases. Main Outcome Measures: Maternal morbidity and mortality due to abnormal placentation Sample Size: 521 patients Results: The establishment of a placenta previa team led to an increased prevalence of placenta previa, from 4 to 13.32 in 1000 deliveries, without increased maternal morbidity or mortality. Furthermore, it enhanced patient experience and resulted in satisfactory maternal outcomes. Conclusion: Management of placenta previa and placenta accreta spectrum by a well-coordinated team was cost-effective and markedly reduced maternal morbidity and morbidity. The involvement of this team also improved patient experience, especially in cases in which high-risk interventions were required. Limitations: Retrospective, single-center study; lack of statistical analysis; lack of a validated tool to differentiate treatment strategies