Background:. Missed abortion occurs in 11% of clinically recognized pregnancies and is not only associated with substantial healthcare and financial burden but non continuing pregnancy is upsetting for mother. Majority of missed abortion occurs spontaneously however some pregnancies simply stop growing without any obvious symptoms, with a deferment in expulsion of conceptus. Misoprostol is a Prostaglandin analogue being widely used for termination of pregnancy, considering it efficacious, low cost and long shelf life (2 years) at room temperature. Objectives: To assess and evaluate the efficacy of misoprostol by oral route, for the medical management of first trimester missed abortion. Material and Methods: This was a prospective study which was conducted at the Gynecology Department of Career Institute of Medical Sciences and Hospital over a period of one year from January, 2016 till December 2016 in which 250 eligible participants were included. All women eligible to be recruited in this study were admitted in hospital and given 200 µg of misoprostol orally at 12 hour interval for 2 successive days, with a maximum of 4 doses. For the present study ethical approval was granted by the institutional ethical review committee of Career Institute of Medical Sciences and Hospital. Written informed consent was obtained from all participants prior to recruitment having explained comprehensively the process involved, intervention given (Misoprostol) and benefits/ risks of being the part this research. Results: Among 250 participants, success in abortion with Misoprostol was observed in 225 (90%) of patients with majority (80.2%) success being achieved with two doses. The most common side effects observed with Misoprostol dose of 200 µg was cramping/ abdominal pain (36%). The mean gestational age in weeks and parity were 10.01 weeks and 2.5 respectively. Conclusion: The study highlighted high success rate and minimal side effects with the use of 200 µg of oral misoprostol for missed abortion.