Aim of the work: A randomized trial comparing the efficiency, safety and success of vaginal misoprostol with oral methergine; in management of incomplete abortion less than fourteen weeks of gestation.Patients and methods: This study included one hundred twenty women attended the casualty ward of the department of obstetrics & gynecology at Cairo University hospitals presenting with spontaneous incomplete abortion less than fourteen weeks of gestation with endometrial thickness more than 15mm as detected by transvaginal ultrasonography. The patients were divided into three groups: Group A (misoprostol group) (n=40) received vaginal misoprostol of 200mcg on six hourly intervals for a maximum of two weeks duration. Group B(methergin group) (n=40) received oral methergine of 0.2mg on eight hourly intervals for a maximum of two weeks duration. Group C (misoprostol & methergine group) (n=40) received vaginal misoprostol of 200mcg on six hourly interval and oral methergin of 0.2mg on eight hourly intervals for a maximum of two weeks duration.Results: throughout this study we found no statistically significant differences comparing the three groups regarding occurrence of fever, severe bleeding and the clinical data of the participants. Significant statistical difference was revealed only when comparing the duration needed for each group to reach completion of the abortion. This means that using both drugs together may give the benefit of decreasing duration needed for treatment without increase in incidence of side effects.