Background: The levonorgestrel-releasing intrauterine system (LNG-IUS), Mirena, which prevents pregnancy for 5-7 years, has been determined to be highly effective, safe and well tolerated in the majority of users. Acceptability studies of the LNG-IUS in Zimbabwe have not been completed. Zimbabwean women have a need for access to long-term contraception that is safe, effective and acceptable. Objective: Explore user continuation rates and the perspectives of new users on acceptability of the LNG-IUS device. Design: Case series of 250 new users evaluated by quarterly surveys for the first year of use. In-depth interviews for a sub sample of 40 new users at 6 months time or sooner if discontinued method. Outcome: Acceptability of LNG-IUS measured by continuation and users perspectives on the new method.