Abortion is the most common complication of early pregnancy, so that should be effectively managed with safe and appropriate procedures. Surgical evacuation of the uterus for management of first trimester abortions usually involves vacuum aspiration or sharp curettage. Objective:To compare the complications of electric vacuum aspiration (EVA) and sharp curettage (D&C) for first trimester abortions, and detect the method that ensure more safety and efficacy. Subjects and methods: The study included one hundred women with incomplete abortion, missed abortion or blighted ovum, gestational age less than 12 weeks whom come to the department of obstetrics and gynecology at Al-Assad university hospital in Lattakia , Syria between 1 July 2013 and 1 July 2014. They were allocated into two groups, group A (n = 50) underwent EVA and group B (n=50) underwent D&C. The procedures were performed using the general anesthesia. We excluded: febrile state, clotting disorders, sever medical and surgical complications, unstable hemodynamic state. Results: Clinical characteristics were similar in the two groups. There were no reports of maternal deaths, cervical laceration, uterine perforation or blood transfusion recorded in the two groups. Blood loss was greater with D&C group than with EVA group (0.001). need an analgesic was greater with D&C group than with EVA group (0.002). Duration of operation and hospitalization was significantly shorter with EVA group than with D&C group. The two groups were similar in success procedure. Conclusion: The efficacy of EVA was the same as that of D&C in successful the procedure, but pain and blood loss were experienced more in the D&C group.