BACKGROUND: Manual vacuum aspiration has been used internationally for many years and been shown to be safe and effective for early abortion, menstrual regulations and completing incomplete abortions. Hence proper training of health workers on the use of this simple and inexpensive medical device- the manual vacuum aspiration instrument, will help in preventing the morbidities and mortality associated with unsafe abortions. OBJECTIVE: To document the main indications of manual vacuum aspiration and outcome of the procedure in Alex Ekwueme Federal University Teaching Hospital Abakaliki. METHOD: A retrospective review of MVA records book of patients who underwent MVA was carried out in Obstetrics and Gynaecology department of Alex Ekwueme Federal University Teaching Hospital Abakaliki from 1st January 2020 to 31st December 2023. Data were collected in a pre-designed proforma and analysed for age, marital status and parity, gestational age, presenting complaints, indications, analgesic methods used and complications following the MVA. RESULTS: During the study period, 512 case files of patients who underwent Manual Vacuum Aspiration were retrieved. However 12 of the case files lacked complete information needed for the study and were not analysed. The remaining 500 case files that had complete information of the patient were analysed in the study. Most of the patients 162 (32.4%) were in the age bracket of 25-29 years, and the mean age of the participants was 28.56± 3.35 years. Majority of the patients were married (88.0%) and nulliparous women accounted for highest number of cases 229 (45%). Most of the patients 230 (46.0%) had the procedure at 7-9 weeks of gestation. Bleeding per vagina was the most common presentation at a rate of 248 (49.6%). While the commonest indications for MVA were incomplete miscarriage at a rate of 420 (84.0%). Majority of the patient had pentazocine and diazepam 244 (48.8%) as a form of analgesics. Pain was recorded as the commonest immediate complication of MVA at a rate of 340(68.0%). CONCLUSION: MVA is an effective alternative to conventional suction curettage, avoiding general anaesthesia and need for access to theatre. Complications such as uterine perforation, bleeding and retained products of conception are minimal when done at or below 12 weeks gestational age. Thus, safe, easily performed and possibly cost effective procedure, with advantage for both patient and the health care system.