BACKGROUND: Recently, preferences for preserving reproductive potential has sparked increasing interest in the conservative management of placenta accreta, increta, and percreta. CASE: A 23-year-old gravida 3 para 2 had a vaginal delivery complicated by retained placenta. The placenta was delivered in multiple fragments followed by sharp curettage. Her postpartum course was complicated by pelvic pain and menorrhagia, unrelieved by sharp curettage. Four months postpartum, transvaginal ultrasonography and magnetic resonance imaging demonstrated an intramyometrial mass. Exploratory laparotomy was done with wedge resection of the anterior wall of the uterus under real-time ultrasonographic guidance. Pathologic examination found placenta increta. CONCLUSION: Conservative management of placenta increta can be used selectively to preserve reproductive potential.