Introduction: The aim of this study was to compare the effectiveness of Manual Vacuum Aspiration (MVA) and Electric Vacuum Aspiration (EVA) for first-trimester abortion. Methods: This hospital-based interventional study involved antenatal patients up to 12 weeks of gestation seeking abortion services at the Department of Obstetrics and Gynecology, Muzaffarnagar Medical College, Uttar Pradesh. Patients were randomly assigned to either the MVA group or the EVA group, with 50 patients in each group. Univariate sampling was employed to assign patients to either MVA or EVA groups. Results: The findings indicate that while there are no significant differences in age distribution, gestational age, BMI, and amount of Propofol used between the two methods, notable distinctions were observed in specific areas .MVA procedures were significantly shorter compared to EVA, suggesting a potential benefit in terms of reduced operation time. MVA proved better in cases of incomplete abortions, while EVA had a higher rate of success in cases of missed abortions, indicating different profiles of procedural efficacy. Conclusion: Both methods had unique risk profiles, with EVA linked to higher risks of uterine rupture and haemorrhage, while MVA had higher rates of incomplete evacuation and retained products of conception. The study emphasizes the importance of personalized medical care in choosing between MVA and EVA for first trimester abortion.