Short-term quality of life following abortion is poorly characterized. We conducted a prospective cohort study to evaluate 97 U.S. women who selected either medical abortion with mifepristone and misoprostol or surgical abortion up to 9 weeks gestation in a private-practice setting. Women choosing medical abortion and those choosing surgical abortion with local anesthesia were similar on most baseline characteristics. Eighty-five participants completed a standardized quality of life assessments three times over 1 month. The 30-item questionnaire yielded scores for global health, emotional, social, cognitive and physical functioning and for specific symptom scales. At baseline, participants reported many symptoms and functional limitations during the previous week. Subjects in both treatment groups experienced clinically and statistically significant improvements on all scales at follow-up. Surgical abortion patients had worse scores on three of five function scales and several symptom scales at baseline compared to medical abortion patients. Differences in baseline scores between the medical and surgical abortion patients disappeared during follow-up. A surprising finding was that partner knowledge of the pregnancy at the time the abortion appointment was made was associated with significantly worse scores on most of the function and symptom scales. These results provide substantial reassurance that women undergoing abortion experience a marked improvement in their quality of life after the abortion. Women choosing medical or surgical abortion report very similar quality of life improvements.