Placenta percreta complicating pregnancy in the first trimester is extremely rare, and only a few cases have been reported in the literature. We recently reported on a patient with risk factors for placenta percreta that presented as first trimester fetal demise, unresponsive to medical management with prostaglandin. The patient required an emergency hysterectomy to control the bleeding after uterine curettage, and was complicated by severe consumption coagulopathy. This rare entity can lead to significant mortality and morbidity, particularly in the background of increased prevalence of the disease and its associated risk factors, and the large number of spontaneous and induced abortions performed worldwide. Therefore, we also reviewed all reported cases of first-trimester placenta percreta in the literature to increase the awareness of physicians and to highlight the clinical features and essentials of the management.