The aim of this study is to assess unsafe abortion and its effects in Menoufyia and Assiut governorates. A cross-sectional analytic design. The study was conducted in general hospitals, MCH centers, and households in Menoufyia and Assiut governorates. Subjects: The sample has included all the cases of unsafe abortion recorded in the general hospitals in the two governorates for a whole year, 138 in Menoufyia, and 304 in Assiut. Records of MCH centers in the study settings were used to identify subjects to be interviewed in households to fulfill the required sample of 1000 in each governorate. Data collection tools: Three tools were used. A personal interview sheet was used for the community-based sample of women. It contained queries about reproductive history, and details of the aborted pregnancy. The second tool was a checklist designed for recording data abstracted [Tom medical files of the record-based sample of women. The third tool was a psycho-social scale for assessment of psychological and social effects of unsafe abortion on woman. Statistical analysis: Data entry and analysis done on Epi-info 6.04 statistical software package, using Student t-test, chi-square, and Fisher tests, with statistical significance set at p-value 0.05.:Women' illiteracy in Assiut was 60.3%, and 46.3% in Menoufiya, the majority, were housewives. The mean age was 31.03±8.15 years in Assiut and 32.42±8.22 in Menoufiya. Economic status was the main reason for terminating pregnancy. The most frequently adopted method was carrying heavy loads (25.4% and 36.3%) jumping [Tom height (16.5% and 24.2%), and drinking boiled onion peels (19.4% and 23.4%) in Assiut and Menoufiya, respectively. However, it was practiced by 13.6% and 15% of cases, respectively. The majority of women agreed that family planning was better than unsafe abortion to get rid of unwanted pregnancy. From the record-based sample, the crude and estimated rates of unsafe abortion based were estimated, and were statistically significantly higher in Assiut. The majority of women in both governorates suffered from complications, mainly bleeding, followed by gastrointestinal disturbances. One patient from Assiut and three from Menoufiya died.It is recommended to integrate patient education and counseling at all levels of woman's care; premarital, antenatal, postnatal and family planning. Involving husband and mother-in-law is important. A family planning follow-up schedule is suggested. Lastly, there is a need for specialized related population-based studies in sociology, anthropology, behavioral sciences, as well as in pharmacology and toxicology.