Background: Missed Abortion is non-viable intrauterine pregnancy with either an empty gestational sac or a gestational sac contains an embryo without fetal heart activity. Objectives: The aim of this study was to compare effect of misoprostol with clomiphene citrate, misoprostol with letrozole and misoprostol alone in terminating first trimester missed abortion. Patients and methods: This randomized clinical trial was included patients with missed abortion attending to our outpatient clinic at