Objectives: To assess the efficacy, safety, and acceptability of early termination of pregnancy by vaginal administration of a single dose of misoprostol. Setting: Healthy women seeking abortion in an institutional research environment in a tertiary-care hospital. Design: Prospective randomized controlled clinical trial. Participants: One hundred forty women seeking termination of pregnancy up to 49 days' gestational age were alternatively assigned to undergo medical or suction termination. Intervention(s): Saline-soaked prostaglandin E, analogue, misoprostol (800 mu g), was administered vaginally in group I, and group II underwent suction evacuation. Transvaginal sonography was performed on two subsequent visits to assess outcome. Main Outcome Measure(s): Efficacy, side effects, complications, and acceptability were assessed in both groups. Result(s): Complete abortion rate between the misoprostol and the surgical group was 94.2% versus 95.5%, respectively. Side effects were fewer in the misoprostol group and it had a higher acceptability rate. Conclusion(s): Single dose of vaginal misoprostol alone has a success rate comparable with surgical method for termination of early pregnancy. Side effects were fewer in women who received misoprostol, and the method was well accepted. (Fertil Steril (R) 2009;91:28-31. (c) 2009 by American Society for Reproductive Medicine.)