First trimester surgical abortion is a very common, effective, and safe procedure. When a woman presents requesting pregnancy termination, counseling regarding pregnancy options and procedural risks, as well as a careful preoperative assessment are vital to a successful outcome. If a patient decides to undergo a surgical abortion, either an electric or manual vacuum aspiration may be performed, based upon provider preference. Complications of first trimester surgical abortion occur in only 0.5% of all cases and include: failed abortion, incomplete abortion, hematometria, hemorrhage, infection, and uterine perforation.