Recent seismic reflection data across the Japan Trench show that frontal accretion involves offscraping sediments on top of horsts and scooping-up sediment from grabens. However, seismic profiling does not illuminate the structure within the accretionary prism, and thus the processes of accretion and prism growth are unknown. Key data from scientific drilling at Integrated Ocean Drilling Program Site C0019 that penetrated the prism in the region of large displacement during the 2011 Tohoku earthquake support a model in which frontal accretion occurs by imbricate thrusting, folding, and stacking of thrust sheets that are composed of semicoherent-sediment strata. Using palinspastic restoration techniques, we conclude that out-of-sequence thrusting and duplex development during the underthrusting of horsts can form and displace hanging-wall ramps along the plate-boundary detachment, which helps to explain the formation of some unexpected tectonostratigraphic relations at C0019, such as the emplacement of a thick section of the youngest sediments at the base of the accretionary prism, and numerous juxtapositions of different-age sediments within the basal plate-boundary fault zone.