Objectives : To evaluate and compare the efficacy, benefits, acceptability and drawbacks of misoprostol and surgical evacuation in the management of spontaneous abortion. Material and Methods : The present study was conducted on 80 patients admitted in labour room or wards of the Department of Obstetrics and Gynaecology, with confirmed diagnosis of spontaneous abortion. The patients were divided into two groups (40 each) randomly. Group I - Received 600g misoprostol per vaginum, repeated after 24 hrs. if products of conception not expelled and considered failure if there was incomplete expulsion even after second dose. Group II Surgical evacuation done under general anaesthesia.