Presentation Misoprostol is utilized for the clinical administration of unnatural birth cycle as it is more compelling in the beginning phases of pregnancy. Letrozole has an enemy of estrogen impact and is utilized for the pretreatment of premature delivery with misoprostol. Intend To look at the viability and wellbeing of letrozole with fake treatment pretreatment in the clinical administration of first trimester missed unsuccessful labor. Plan an imminent randomized twofold visually impaired case-control study.Patients and Methods Patients with missed unsuccessful labor of pregnancy as long as 63 days. 320 ladies were arbitrarily isolated into two gatherings of 160; the fake treatment bunch got fake treatment tablets once day by day for 3 days, trailed by 800 micrograms of misoprostol vaginally on the Third day of enrolment, while the letrozole bunch got letrozole 7.5 mg once every day for three days followed by same portion of vaginal misoprostol. The total fetus removal rate and Hb shortage of the two gatherings were looked at. The essential result measure was the finished fetus removal rate. Results A sum of 320 ladies were enrolled. The total premature birth pace of the letrozole bunch was fundamentally higher than that of the fake treatment gathering (82.6% contrasted and 68.2% (p < 0.001). There were noteworthy Hb shortage in letrozole gathering (p= 0.011) with non-huge factual distinction deprived for blood bonding. End Adding letrozole to misoprostol is related with a higher complete fetus removal rate