Background :This study was conducted to evaluate the efficacy and safety of 200 μg misoprostol administered vaginally every 4 hours to a maximum of 48 hours for second trimester intrauterine fetal death. Methods: We conducted a prospective, randomized trial comparing the efficacy and safety of misorostol either in its dry form (group A) or moistened with 1 ml saline (group B). The study population included 136 pregnant women between 14 and 24 weeks gestation who were seeking for termination of pregnancy because of intrauterine fetal death. Setting: Woman’s Health Center, Assiut University Hospitals. Results: All patients in both groups aborted within 48 hours (100% success rate), the median induction-abortion interval was significantly shorter in group B than in group A (p<0.01) patients in group B had significantly short median induction-abortion interval(p<0.01) , less total number of doses (p<0.05) , less retained placenta ((p<0.05), more aborton within 24 hours (p<0.01), more aborton with the 1st dose(p<0.01) but had more need for analgesia and more incidence of side effects (p<0.01). Conclusion: The intravaginal administration of 200 μg misoprostol tablets moistened with saline every 4 hours was effective for second trimester pregnancy termination and superior to dry misoprostol tablets. However it was associated with more side effects whisch were well tolerated.