Abstract Medical treatment using misoprostol has been recommended as an alternative to surgical evacuation for missed miscarriage in the first trimester in order to avoid anesthesia, surgical operation and hospitalization. Our aim is to assess the efficacy and safety of vaginal misoprostol in out-patient management of early miscarriages. This prospective study included patients with missed miscarriage of ≤10 weeks gestation. The protocol used 800 microgram of misoprostol on day 1 at clinic, followed by another dose of 800 microgram of misoprostol on day 2 if miscarriage was not complete. The included 150 patients, had missed miscarriage or anembryonic pregnancies. The success rate defined has complete miscarriage without need for surgical evacuation and without shortterm complications. Complete expulsion occurred within 2 days in 90.7% of cases. There were 14 patients needed surgical evacuations and admission to hospital (5 for method failure, 2 for incomplete miscarriage and 7 according to women decision). No one required blood transfusion. In conclusion, it is possible to use misoprostol as an out-patient treatment, since it gives satisfactory efficacy and is sufficiently safe.