Background: To compare the safety and efficacy of oral versus vaginal misoprostol in induction of midtrimester abortions. Methods: We conducted a retrospective comparative study at the postpartum unit of the department of obstetrics and gynaecology, Government Medical College, Amritsar from January 2022 to September 2024.The available record of 125 patients who underwent termination of pregnancy between 13 and 24 weeks of pregnancy was analyzed. The outcome data of women undergoing midtrimester abortion(Group A) with vaginal misoprostol(n= 64 ) was compared with a contemporaneous cohort of women undergoing midtrimester pregnancy interruption (Group B) with oral misoprostol(n=61). The procedure efficacy and safety of the procedure were assessed. Results: There was complete foetal expulsion in all cases in Group A (100%) while the success rate was 90.16% with oral misoprostol in Group B. The median induction to abortion(IAI) interval was significantly shorter in Group A(6.80 ± 1.1 versus 9.46± 2.69hours; p=.000). The median amount of vaginal misoprostol (800ug) used in Group A was significantly less than the oral dose used in Group B(1200ug).The side effects in the vaginal group were less as compared to the oral group due to the higher dose of misoprostol used in the oral group. Conclusion: The present study confirmed that vaginal misoprostol is generally more effective than oral misoprostol hence should be the preferred method. Just resorting to the vaginal route reduces the total dosage of misoprostol required for termination and shortens the termination interval thereby increasing the patient comfort.