BACKGROUND We wanted to determine the outcomes of medical abortions in four family practice centers. METHODS This study was a retrospective case series of consecutive medical abortions in four community health centers between November 2000 and April 2002. We defined a successful medical abortion as one that required no further intervention after the administration of the medications mifepristone and misoprostol. The subset of abortions in patients who had suction procedures were called failures. RESULTS In this series of 236 abortions, only 1 woman had a viable pregnancy after taking the medication as directed, and she had an elective suction procedure to terminate the pregnancy. None of the patients under the complete care of family physicians received suction procedures for other indications. Two patients underwent suction procedures at other institutions for unknown indications. Eight were lost to follow-up. One did not adhere to the protocol and so was excluded from the data analysis. The failure rate of the protocol for patients cared for by the family physicians at follow-up was 0.4%. CONCLUSIONS Medical abortion in a family practice setting is a safe and effective procedure. If practiced widely, it could make abortion care much more accessible to women.