Objective To access an ideal procedure terminating missed abortion within 12 weeks of gestational age. Methods Women with intrauterine fetal death were randomized into 3 groups. Group A (n=30): vaginal misoprostol (MP) 0.4 mg, 3 h before vacuum aspiration; group B(n=15): vaginal MP 0.4 mg every 3 h, up to 5 doses; group C(n=30): oral mifepristone (MF) 200 mg 36-48 h before vaginal MP 0.4 mg, MP was given every 3 h, up to 5 doses. Results Women in group A had the shortest interval of gestation tissue expulsion (3.2 ± 0.5 h) and the bleeding (3.2 ± 5.7 ml) during medical procedure, which were statistically significant in comparison with the other two groups (P<0.001, P<0.01, respectively). Success rates of groups A, B and C were 100%, 33.3% and 90.0%, respectively. Percentages of women need surgical interventions were similar in group B and group C(80.0%,76.7%, respectively). Bleeding during operation, pain after medical procedure and satisfaction presented no statistical significance among the 3 groups. Conclusion Vaginal MP followed by vacuum aspiration was valuable in safety, and efficacy, which led to less bleeding and a faster recovery. Objective To access an ideal procedure terminating missed abortion within 12 weeks of gestational age. Methods Women with intrauterine fetal death were randomized into 3 groups. Group A (n = 30): vaginal misoprostol (MP) 0.4 mg, 3 h before vacuum aspiration; group B (n = 15): vaginal MP 0.4 mg every 3 h, up to 5 doses; group C (n = 30): oral mifepristone (MF) 200 mg 36-48 h before vaginal MP 0.4 mg, MP was given every Results Women in group A had the shortest interval of gestation tissue expulsion (3.2 ± 0.5 h) and the bleeding (3.2 ± 5.7 ml) during medical procedure, which were significant significant in comparison with the other two (P <0.001, P <0.01, respectively). Success rates of groups A, B and C were 100%, 33.3% and 90.0%, respectively. Percentages of women need surgical interventions were similar in group B and group C (80.0 %, 76.7%, respectively). Bleeding during operation, pain after medical procedure and satisfaction presented no statistical significance among the 3 groups. Conclusion Vaginal MP followed by vacuum aspiration was valuable in safety, and efficacy, which led to less bleeding and a faster recovery.