Pregnancy in patients who have had prior pelvic radiation has been associated with spontaneous abortion, preterm labour, preterm birth, fetal growth restriction and abnormal placentation (Critchley and Wallace 2005; de Menezes and Tuck 2007; Pridjian et al. 1990; Norwitz et al. 2001). Similar outcomes have been reported following successful childhood treatment of Wilms tumour with abdominal and/or pelvic radiation (Kalapurakal et al. 2004; Li et al. 1987). We present a case of cervical insufficiency and placenta accreta after childhood treatment for Wilms tumour.