We sought to determine if female community health volunteers (FCHVs) and literate women in Nepal can accurately determine success of medical abortion (MA) using an 8-question symptom checklist. Women’s and FCHVs’ assessments were compared to experienced abortion providers using standard of care. Women’s self-assessment of MA success agreed with abortion providers’ determinations 85% of the time. Agreement between FCHVs and providers was 82%. We concluded that use of a checklist to determine MA success is a promising strategy. However, further refinement of such a tool, particularly for low-literacy settings, is needed before widespread use.