Background: Vaginal misoprostol is preferable than oral misoprostol in the first trimester of pregnancy, according to clinical research. Objective: Comparing the success rate, tolerability and side effects between oral and vaginal 600µg misoprostol in the management of blighted ovum. Subjects and Methods: Our study was carried out on 100 pregnant women diagnosed as blighted ovum, admitted to the Obstetric Unite in Al-Galaa Teaching Hospital and after careful. U/S examination and after second opinion examination all of the participants were informed about the procedures and the possible failure of our study. Two groups were created (50 in each group), (A) took misoprostol orally and (B) group took misoprostol virginally. Results: The gestational ages did not differ significantly between the two groups of participants (P>0.05). Patients who successfully completed medicinal abortions and those who needed surgical evacuation were not statistically different. Also, according to side effects, there was no statistically significant difference in the two groups (P>0.05) except for diarrhea and vomiting, which were significantly increased in oral group. Conclusion: Using oral and vaginal misoprostol 600µg as medical managing for a blighted ovum, their effectiveness is practically identical.