INTRODUCTION:: The objective of this study is to determine the safety and efficacy of routine prophylactic measures to prevent surgical complications during peripartum hysterectomy for placenta accreta spectrum, including placement of pelvic vascular occlusion catheters (PVOC) for uterine artery occlusion or embolization (UAE) and ureteral stents (US). METHODS:: This is a retrospective cohort study of women undergoing peripartum hysterectomy for pathologically confirmed placenta accreta spectrum from December 1, 2007 to June 30, 2019. Medical records were reviewed for intraoperative details and surgical outcomes, including use of, and complications related to PVOC, UAE and US. Women who had any prophylactic procedure were compared with those that had none. Primary outcome was complications related to use of each prophylactic measure. Data were analyzed using univariate and multivariable techniques. RESULTS:: A total of 71 women underwent peripartum hysterectomy. 45 women had at least one prophylactic measure: 40 had PVOC or UAE and US, and 5 had US only. Use of any prophylactic measure was associated with an increase in total operative time (P<.0001) and a decrease in blood loss (P<.0001), need for transfusion (P<.001) and maternal ICU admission (P<.001). There were no complications related to US placement, and one complication related to PVOC. There were no differences in rates of ureteral injury, bladder injury or bowel injury between women that had prophylactic measures and those that did not. CONCLUSION:: Routine use of prophylactic measures at cesarean hysterectomy, including PVOC and US appear to be safe and associated with decreased blood loss and maternal ICU admission.