Background: Mechanical cervical dilatation in first trimester has been associated with some risk of cervical injury and incompetence of cervix resulting in premature labour and spontaneous abortion in subsequent pregnancies. The present study compared efficacy of Intra-cervical Carboprost as a cervical ripening agent as compared to Intravaginal Misoprost in first trimester abortion. Materials & Methods: This study was done in department of Obstetrics and Gynaecology, Provincial Hospital, Janakpurdham, Nepal after prior consent from patients and clearance from the ethical committee. Sixty patients with first trimester abortion/MTP were taken into the study and divided into two groups. In 30 patients, pre-operative ripening of cervix was attempted using Intra-cervical Carboprost under aseptic conditions and direct vision; and in the rest 30 using Intra-vaginal Misoprost. Pre-operative cervical dilatation was recorded. In the first group, under direct vision using Cusco’s / Sim’s Speculum Carboprost injection was given at 4 and 8 o’clock on the cervix after cleaning the cervix using sterile gauze with normal saline. In the second group, under aseptic precautions, 800 ug Intravaginal Misoprostol was inserted after moistening with normal saline. After 30 minutes dilatation of cervix was checked. Results: In group I, there were 18 patients with age <30 years and 12 with age >30 years. Parity was 11 with Primi and 19 multi. In group II, there were 20 patients with age <30 years and 10 with age >30 years. Parity was 13 with Primi and 17 multi. In group I, Mean dilatation of 10mm was reached after 3-4 hours, vaginal bleeding was present in 26 patients, 23 had pain, 4 had fever and 4 had nausea and vomiting. In group II, mean dilatation of 10 mm was reached after 40 mins, vaginal bleeding was present in 16 patients, 11 had pain, and 3 had nausea and vomiting. Conclusion: Intra-cervical Carboprost seems to be an exquisite armamentarium to the Obstetrician as it takes lesser time for cervical dilatation, hence useful when in emergency and when quality of life of pregnant female is hampered by longer induction to abortion interval. It has better efficacy as it is site specific. It is more tolerated by the patient as it has lesser systematic side-effects as compared to Misoprostol and Intra-muscular Carboprost like bronchospasm, diarrhoea, nausea, vomiting etc.