Clinical audit comes under the clinical governance umbrella and forms part of the system for improving the standard of clinical practice. Many organizations worldwide have published standards for intrauterine device (IUD) use and removal. There is no audit that has been published about using IUD in Egypt; therefore, our objective was to audit the current IUD insertion and removal, identifying the gap between the current practice and ideal practice and setting recommendations to fill the gap to improve client satisfaction and minimize complications and to reaudit the magnitude of improvement. A total of 500 IUD insertion/removal clients (350 cases for preaudit and 150 cases for postaudit) were included in the study. There were statistically significant improvement in several preinsertion, insertion, postinsertion, preremoval, and removal steps of IUD in postauditing in comparison to preauditing, but there are no statistically significant differences in the frequency of all postremoval steps of IUD in postauditing in comparison to preauditing. The present audit identified a gap in a number of items that were partially improved in the reaudit phase and this indicates the value of audit in IUD insertions and removal steps.