Background: The incidence of placenta accrete spectrum(PAS) has increased dramatically over the last few decades in concordance with the increase in caesarean section rate. The torrential haemorrhage associated with this condition results in severe maternal morbidity and mortality. Aim: To analyse the various surgical procedures used in PAS to achieve effective haemostasis with the objective of reducing maternal morbidity and mortality. Methods: We conducted a retrospective analysis of the data from 36 cases of PAS managed from October 2023 to December 2024 at a tertiary care academic medical centre in Government Medical College, Amritsar. The study protocol included demographic data, obstetrical history, surgical manoeuvres used, operation time, estimated blood loss, pregnancy outcome and maternal complications, length of hospital stay and re-admission. The comparison group included cases of major degree placenta praevia with no features of placenta accretism. Results: The mean age of patients with PAS was 31.1±4.2 years. All patients had undergone previous caesarean delivery with average of previous two caesarean sections. 29 patients had planned surgery as they were diagnosed in the antenatal period while the rest were diagnosed during the caesarean delivery.33 patients were operated upon between 32 to 38 weeks of gestation. Elective surgeries were performed in 33cases. Caesarean hysterectomy alone was performed in 11cases while it was combined with hypogastric artery ligation in 8 cases. Uterine sparing surgery in the form of stepwise uterine devascularisation with or without hypogastric artery ligation was performed in 7 cases. However, compression sutures alone or with IIAL or the use of Bakri balloon was effective in a few cases of PAS where placenta accretism was focal in aspect. Average blood and blood components therapy was 6 to 8 units. Ionotropic support was required in 22 cases and ICU and HDU care in 13 cases. Ventilator support was used in 8 cases. Bladder injury occurred in 2 cases. There was one case of maternal mortality. Conclusion: Hypogastric artery ligation combined with caesarean hysterectomy or stepwise uterine devascularisation had much better outcomes especially in women undergoing planned surgery for PAS with fewer blood transfusions, lesser ionotropic support and shorter hospital stay. This significantly decreased the maternal morbidity and mortality.