Approximatly one in four women will experience a miscarriage during her lifetime. For more than 50 years, the standard management of early pregnancy failure has been a dilatation and curettage (D&C).Typically, the procedure is performed in an operating room, which significantly increases cost. There is little objective information in this literature to prove that a D & c for all patients will lower morbidity or improve emotional well being. Treatment options include expectant management D&C, and medical management with misoprostol.This study support that with use of ultrasound in surgical evacuation in first trimester abortion showed significant in less bleeing intraoperative &less perforation rate, less procedure time & less post operative bleeding and that the use of ultrasound is the real important step in performing surgical evacuation, but the study didn’t implay to the importance or difference in using ultrasound through the whole procedure or only at the beging and end of procedure to confirm empty uterus.