Abstract Objectives: To compare the efficacy and safety of two uterine sparing techniques in conservative management of placenta accreta spectrum (PAS). Methods: This multicenter randomized controlled study was conducted from January 1, 2017 to December 31, 2020 at two university hospitals. Patients were randomly allocated into two groups; Group 1 was managed by Assar's technique and Group 2 was managed by Shehata's technique. Operative time, blood loss, operative complications (organ or vessel injury), and postoperative complications (early and late) were reported. Success of the technique, units of blood transfusion, and intensive care unit admissions were recorded. Results: Demographic data in both groups were not significantly different. The mean gestational age at the delivery time was 36 weeks in both groups. Operative time was 120 (100–140) minutes and 75 (60–100) minutes in Assar's and Shehata's techniques, respectively (P