This study assesed the severity of abortion complications in Malawi and determined associated risk factors. Between July 20 and September 13, 2009, a cross-sectional survey was conducted at 166 facilities providing postabortion care services. Data were collected for all women with an incomplete, inevitable, missed, complete, or septic abortion. Women with severe or moderate complications were significantly more likely to be from rural areas than from urban areas; to have reported interfering with their pregnancy; and to be separated, divorced, or widowed than to be single. The study concluded that advocacy is needed to influence policies that will allow expanded access to safe abortion services for women of all ages and in all areas.