Objective To compare clinical efficacy of three cervical preparations for surgical evacuation in first trimester missed abortion.Methods Two hundred and ten women with early missed abortion were equally randomized into three groups.Three cervical preparations,Dilapan-dilator method (group A,n =70),mifepristone method (group B,n=70),and misoprostol method (group C,n=70),were used 24 h before curettage for terminating missed abortion,respectively.Clinical outcomes and complications for these three methods were compared.Results No differences were found in rates of successful treatment among the three groups (P＞0.05).The incidence of fitting number 8 Hegar dilator was slightly high in group A,but it was not different compared with that in group B or group C (P＞0.05).Bleeding in previous 24 h in group C was significantly greater than that in group A or group B (P＜0.01).The cases of blood loss (＞50 ml) during evacuation in group B were more than those in group A (P＞0.05).Women in group B had less abdominal pain than those in group A or group C (P＜0.01).Side effects in group C were more than those in group A on nausea (P＜0.01),vomiting (P＜0.05),and diarrhea (P＜0.01).Group B had the highest acceptability among the three groups (P＜0.05).Conclusion Three methods have the similar clinical efficacies in cervical ripening for surgical treatment of early missed abortion.Based on individual characteristics,different approach would be chosen to avoid some adverse events and improve the clinical application of Dilapan-dlilator.