Placenta accreta Is an obstetric complication where the placenta becomes firmly adherent to the uterine wall. Retained placenta accreta may cause post–partum haemorrhage that can lead to peripartum hysterectomy. Here we present a case of retained placenta accreta in an undiagnosed bicornuate uterus, which was managed conservatively using injection methotrexate, systematically, thus, preserving future fertility of the patient