INTRODUCTION    Over millions of pregnancies occur each year, approximately 210 million, out of this 22 % (i.e.,) 46 million are terminated by induced abortion  Although ‘medications have been used to induce abortion for centuries, over the last five decades researchers developed safe and effective methods of medication based pregnancy termination. Although a majority of abortions are done in early pregnancy, there is still an increasing need for mid trimester abortion. This is because of delay in the diagnosis of congenital anomalies, delay to recognize an unwanted pregnancy, financial difficulties in obtaining abortion services.       The Mifepristone–Misoprostol combination reduces the interval between induction and abortion significantly, side effects are lesser, with reduced misoprostol dose requirement. Therefore, wherever possible Mifepristone–Misoprostol combination regimen should be used. Routine post abortal curretage should be reduced.Comparative study of Mifepristone–Misoprostol combination and Misoprostol alone in second trimester abortion. MATERIALS AND METHODS This is the Comparative study of Mifepristone–Misoprostol combination and Misoprostol alone in second trimester abortion.     Data for the comparative study will be collected from labour ward and out –patient clinics of Govt. Raja Mirasuclhar Hospital, Thanjavur  over a period of 10 months (October 2013 to July 2014)          Sample size was 100 pregnant women  and divided in to two group A and B Group A: 50 pregnant women were given 200mg of mifepristone Followed by vaginal Misoprostol 4001ncg alter 36h.rsfollowed by400rncg every 3hrs to a maximum of four doses.  Group B: 50 pregnant were women given 400n1cg of vaginal Misoprostol repeated every 3hrs up to five doses.       Intravenous antibiotics were administered to all patients after instilling  Vaginal Misoprostol. Check ultrasonogram was done post abortion in both the group. Injection Anti–D immunoglobulin was administered to all patients with Rh negative blood within 72hrs of  expulsion. Patients selected for study by subjecting to  Ø History taking – age, parity, socioeconomic status, period of amenorrhoea, mode of delivery in previous pregnancy, marital history, menstrual history, history of any medical illness.  Ø General physical examination – pallor, pedal eodema Ø Systemic examination – pulse rate, blood pressure, cardio vascular system examination, respiratory system examination.  Ø Per abdomen examination – for size of the uterus.  Ø Per speculum examination – to note any cervical lesions or bleeding through os. Ø Per vaginal examination – for size of the uterus.  Ø  Other Investigations  In both the groups, before repeating misoprostol, subjects were enquired about onset of painful contractions, vaginal bleeding or side–effects if any, and per vaginal examination done to note cervical dilatation.  After expulsion of products of conception, examination done to note if  any excessive bleeding per vaginum is there, USG done to note for emptiness of  uterine cavity. OBSERVATIONS AND RESULTS Ø Inn this study, the mean age of the patients in combination regimen was 25.8yrs, the youngest was 19 yrs and the oldest was 35 yrs. The Mean age of patients in Misoprostal alone regimen was 26.7yrs, the youngest was 19 yrs and the oldest was 36yrs. In our study the maximum percentage of patient were in the age range of 21 to 25 yrs.          In our study there was a uniform distribution in parity between Mifepristone – Misoprosto1 group and Misoprostol alone group, most patients were multigravida.  The mean gestational age in the Misoprostol alone group was @ l6.19wks the lowest was 13wks and the maximum was 20 wks. The mean gestational age in the combination group was l6.51wks the lowest was l4wks and the maximum was 20 wks.               Regarding distribution of gestational age among patients 56 of 100 patients were in the gestational age range of 13 to 16 weeks, 44of 100 patients were in the gestational age range of 16.1 to 20weeks.In the misoprostol alone group, majority of the patients 31 out of 50 were in 68  the gestational age range of 13m 16 wks.            In the combination group, 25 out of 50 in the gestational age of 13to l6wks and 25 were in gestational age of 16.1 to20 weeks.  majority of the case were patients who needed and requested MTP in view of failed contraception and social causes, followed by patients with congenital anomalies and maternal conditions warranting termination of pregnancy. 72% and 40% of the patients did not have any side effects in the combination group and misoprostol alone group respectively.  28% (14 Patients) of the patients in the mifepristone – misoprostol group experienced side effects, the most common was abdominal cramps 28% (14) followed by nausea and chills. 60% (30) of the patients in the misoprostol alone group experienced side effects, the most common side effect was nausea 32.9% (25), followed by abdominal cramps l3.2.(l0), vomiting 11.8% (9), chills 6.6%, fever 5.3% and iarrhoea 3.9%. Overall the most common side effect in both the regimen was nausea.          The second most common was abdominal cramps, No grave complications like uterine rupture or maternal mortality were observed in both the groups.  Complete abortion was achieved in 98% (49) of the patients in Mifepristone – Misoprostol group, one case (2%) ended in hysterotomy(failure). Complete abortion was achieved in 88% (44) of the patients in the misoprostol alone group, six cases (12%) required post abortal curettage for excessive bleeding per vaginum, or for USG evidence of retained products.  Over all, complete abortion was achieved in 93 patients in our study. CONCLUSION          The incidence of second trimester abortion has reduced significantly following PNDT act. But when the condition is not favourable (i.e) hazardous to the life of either the fetus or mother, the benefit of termination of pregnancy outweighs the risk of continuing pregnancy. This procedure is not only painful, but also has  psychological impact. It is the obstetricians concern to reduce this stressful period  to the shortest peiod as possible.  This study of pretreatment of mifepristone before misoprostol in  second trimester medical abortion, offers a reliable, safe method with reduced  interval between induction and abortion.  For medical second trimester termination termination of pregnancy, pre–treatment with oral mifepristone 200mg prior to vaginal misoprostol provides a non–invasive effective regimen with significantly reduced  induction to expulsion interval, lesser side effects and good patient compliance.