Objectives: To establish Safety and efficacy of vaginal misoprotol 50 ug/4 hours for 72 hours maximum in second trimester pregnancy termination in women with scarred uterine. Study design: Case control study included 210 women classified into 2 groups: group I (cases) included 80 women with uterine scar and group II (control) included 130 women without uterine scar. Results: There was no significant difference between the study groups regarding doses needed. IAI was shorter in control group than in cases (16.8±10.3 vs. 22.6±11.7). There was no significant difference between the study groups regarding failure of procedure 4(5%) vs. 8(6.15%) women respectively. SE was needed in 17 (21.25%) vs. 24 women (18.46%) respectively (p>0.05). There was no significant difference between the study groups regarding excess blood loss (6.25 vs. 5.38%), need for blood transfusion (2.5 vs. 1.53%), or side effects as fever (20 vs. 15.38%), chills (48.75 vs. 45.38%), nausea (45 vs. 44.61%), vomiting (13.75 vs. 13.07 %) or diarrhea (21.25 vs. 14.61%). Conclusions: Misorostol is safe and effective in induction of second trimesteric abortion in women with scarred uterus.