Objective To investigate the effects of anesthesia management on maternal and fetal prognosis in patients complicated with different types of placenta implantation. Methods A retrospective case review of the patients with placenta implantation between 2009 and 2017 at Peking University First Hospital was conducted in the electronic medical record system, excluding natural birth and artificial abortion, a total of 82 cases were incorporated into this study. According to the degree of implantation, they were divided into three groups: accreta group, increta group and percreta group. We analyzed the anesthesia management and maternal and fetal prognosis. Results The accrete group included 41 cases, the increta group 20 cases and the percreta group 21 cases. There were significant differences among the three groups in anesthetic choices (P＜0.01).In the accreta group, 34 cases (82.9%) underwent spinal anesthesia, 6 cases (14.6%) underwent general anesthesia, and 1 case(2.4% ) was converted to general anesthesia after spinal anesthesia during the operation; in the increta group, 11 cases (55%) underwent spinal anesthesia, 6 cases (30%) underwent general anesthesia, and 3 cases (15%) were converted to general anesthesia after spinal anesthesia; in the percreta group, 2 cases (9.5%) underwent spinal anesthesia, 12 cases (57.1%) underwent general anesthesia, and 7 cases (33.3%) were converted to general anesthesia after spinal anesthesia. The greater the degree of placental implantation, the blood loss was more, the hysterectomy rate of the patient was the higher and 1 minute Apgar score for the newborn was lower. Conclusions Placental implantation is an important determinant of anesthesia management. Spinal anesthesia can be used as the first choice of cesarean section complicated with placenta accreta and general anesthesia should be considered in placenta percreta, especially those who have already placed abdominal aortic balloon catheters. High quality anesthesia manaement and measures can significantly improve maternal and fetal prognosis.