Background: To compare the safety and efficacy of misoprostol in induction of midtrimester abortions in women with or without uterine scar due to previous caesarean section to achieve expeditious vaginal expulsion with minimal maternal complications. Methods: We conducted a retrospective cohort based comparative study at a tertiary care academic medical centre at the postpartum unit of the department of obstetrics and gynaecology, Government Medical College, Amritsar from January 2022 to December 2024. 155 patients who underwent termination of pregnancy between 13 and 24 weeks of pregnancy were identified to develop two contemporous cohorts based on the presence or absence of previous caesarean scar. The outcome data of women undergoing midtrimester abortion with history of at least one previous caesarean section (n= 52) (Group A) was compared with a cohort of women undergoing midtrimester abortion with history of previous vaginal deliveries (n=103) (Group B). The procedure efficacy and safety of the procedure were assessed. Results: Out of 52 women with history of previous caesarean sections, 34 had previous one caesarean birth, 15 women had previous two caesarean deliveries, and 3 had previous three caesarean sections. There was relatively higher number of women with previous uterine scar for induction of midtrimester abortions due to higher referrals of such cases at this tertiary hospital. Women with prior caesarean sections were significantly older; mean age 33years [interquartile range 27-37] P = < .001 as compared to women with previous vaginal deliveries (23 years[interquartile range 18-26])and are also of increased parity. The mean gestational age was 14.6weeks [interquartile range 13.8-20.4 weeks] in women with previous caesarean births as compared to women with previous vaginal deliveries of 15.2weeks [interquartile range 14-20.4 weeks]P =.54 The presence of the uterine scar did not affect the induction to abortion(IAI) interval, the completeness of the abortions or the ensuing complications like the amount of blood loss. Also, the presence of the caesarean scar did not impact the dose of misoprostol needed to induce and complete the process of abortion. The longer interpregnancy interval (>22 months), lesser gestational age(just 14 weeks) nulliparity and lower Bishop Score (<2) at the time of misoprostol usage in both the groups were significantly associated with a poorer outcome. Conclusion: The present results confirmed that the presence or absence of the caesarean scar did not significantly affect the induction abortion interval or the completion of midtrimester abortions. There was no increase in the complication rate in women with previous caesarean scar undergoing midtrimester abortion with misoprostol.