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Introduction. Placenta praevia (PP) is an obstetrical complication where the maturing placenta obstructs a part or all of the internal cervical os. Abnormal placenta invasion and development are associated with a spectrum of conditions rather than a single obstetric pathology. Objective. To review the ultrasound markers for placenta praevia in our experience and correlate the imagistic and histopathological findings. Methodology. This is a retrospective study including 259 patients admitted with the diagnosis of PP in the Obstetrics-Gynecology Clinic II of the County Emergency Clinical Hospital Craiova, Romania, between 2018 and 2023. Results. The most important ultrasound features associated with placenta praevia with accreta were loss of retroplacental hypoechoic area, presence of placental lacunae, presence of bladder wall discontinuity, placental bulge, exophytic mass, subplacental and/or uterovesical hypervascularity, placental lacunae feeder vessels, and bridging vessels. According to the degree of placental invasiveness, the histopathological evaluation showed disorganization of the uterine wall, myocytes anarchically distributed among the villi and decidual cells, neoformation vessels invading the myometrium, and these aspects were correlated with hyperadherence and significant antepartum and intrapartum bleeding. Conclusions. The aforementioned ultrasound features may put doctors on alert and, thus, dictate the appropriate therapeutic management to prevent complications that could endanger fetal or maternal life. [ABSTRACT FROM AUTHOR]