Objective To explore the clinical value of ultrasound and magnetic resonance imaging (MRI) in the diagnosis of adhesive placenta accreta (PIA). Methods The clinical data of 60 PIA patients admitted to our hospital were retrospectively analyzed. All patients were given ultrasound and MRI examinations. The clinical or postoperative pathological results were evaluated as "gold standard", and the features of ultrasound and MRI images of adhesive PIA were analyzed, and the diagnostic value of the two inspection methods was compared. Results Among 60 patients with PIA, 38 cases (63.33%) were adhesive, and 22 cases were non-adhesive of which 19 cases (31.67%) were implanted and 3 cases (5.00%) were penetrating. 51 patients were terminated pregnancy by cesarean section, and 9 cases of vaginal delivery, 7 cases of manual removal of placenta, 2 cases of incomplete hysterectomy, 4 cases of hysterectomy and 4 cases of postpartum hemorrhage rescue. There were 33 adhesive cases, 19 non-adhesive cases, 3 cases of misdiagnosis and 5 cases of missed diagnosis by MRI diagnosis, and the accuracy in diagnosing adhesive PIA were 86.67%. There were 27 adhesive cases, 16 non-adhesive cases, 6 cases of misdiagnosis and 16 cases of missed diagnosis, and the accuracy in the diagnosis of adhesive PIA were 63.33%. The sensitivity, accuracy and negative predictive value of MRI in the diagnosis of adhesive PIA were significantly higher than those of ultrasound (P<0.05). Conclusion Ultrasound can be used as a routine screening method for adhesive PIA, but MRI has better diagnostic efficacy than ultrasound. For patients with suspected adhesive PIA should be given preoperative diagnosis by combining with MRI.