Over the last 40 years, rate of cesarean delivery has risen from less than10% to over 30% around the world, and almost simultaneously a 10-foldraise in the incidence of placenta accrete spectrum. Fine coordinationamong vascular endothelial growth factor, soluble fms-like tyrosine kinase1 and placental growth factor is important for normal placentaldevelopment and trophoblast invasion. To measure and compare the levelsof circulating vascular endothelial growth factor, placental growth factorand soluble fms-like tyrosine kinase 1 in pregnant women with placentaaccreta to a control group. A case control study which involved one hundredpregnant females were recruited from the Obstetric ward in BaghdadTeaching Hospital who were pregnant with 28 weeks of gestation or more,through the period from October 2018 to June 2019. Fifty patients werechosen with placenta accreta that ended with caesarean sectionhysterectomy and the other fifty patients were with normal placentallocation as a control. Means of VEGF, PlGF, and sFlt-1 were significantlylower among case group than that in controls. Cut point of VEGF level was111.83 ng/L, of PlGF level was 23.29 ng/L, and of sFlt-1 was 5.32 ng/ml;so VEGF level < 111.83 ng/L, PlGF level < 23.29 ng/L, and sFlt-1 level <5.32 ng/ml are predictors for risk of placenta accrete. No statisticalsignificant correlations between markers’ level and all characteristics.Angiogenic and anti-angiogenic markers may have a role in thedevelopment of placenta accreta spectrum. VEGF, PIGF and sFlt-1 aredecreased in patients with placenta accreta