This study examined the feasibility of introducing mifepristone-misoprostol medication abortion into existing public sector surgical abortion services in KwaZulu-Natal, South Africa. The sample included 1,167 women seeking first trimester abortion at four public sector facilities; 923 women at ≤9 weeks gestation were eligible for medication abortion. The study concluded that medication abortion was able to be successfully introduced with low and acceptable rates of adverse events and with most women at study facilities opting for this option.