MTP is the commonest and probably the first surgery that any Gynecologist performs when he or she starts private practice. As per India’s abortion laws only qualified doctors, under stipulated conditions, can perform abortion on a woman in an approved clinic or hospital. The Indian abortion laws fall under the Medical Termination of Pregnancy (MTP) Act, which was enacted by the Indian Parliament in the year 1971. Since 1971 there have been two amendments in the act. The chapter focuses on a step by step approach for doing MTP in private practice which is safe medico legally and clinically and includes the details on minimum requirements for being a registered medical practitioner qualified to perform, MTP, when one can perform MTP with medicines, how to apply for registration of the center, Required equipment and set up for recognition of center, procedure for approval of center, details of documents (form A, B, C, Form 1, 2 ,3) to be filled before and after the MTP. One must observe following steps while performing any MTP: Step 1: Take the consent of the patient in Form C, Step 2: Complete the Form I—“Doctors approval form”, Step 3: Complete the MTP, Step 4: Fill the Form 2—MTP reporting format, Step 5: Put these three forms (Form C Form 1 and Form 2) in an envelope, Step 6: Send it to the owner of the center for his/her custody. Every month before the 5th the owner of the center is supposed to send a monthly statement of the MTP cases in Form II to the chief medical officer of the district or MOH in case of cities. It’s an offense if reporting is not done. One has to remember that MTP act recognizes and protect the right to secrecy of the patient and hence her name has to be kept a secret even from her husband. Once a patient comes to us for MTP, enter her name in the “admission register. Admission register has to be maintained for 5 years as a secret document. Some landmark MTP cases are being also discussed in the chapter.