Mifepristone approval by the United States (US) Food and Drug Administration in 2000 revolutionized abortion care in this country. In the aftermath of the US Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization which eliminated federal constitutional protections for abortion, the accessibility and availability of mifepristone are under increasing threat. Medication abortion regimens that do not include mifepristone are therefore of urgent interest. In settings where mifepristone is not available, and especially outside the US, clinicians and people who self-manage abortion have been using misoprostol-only for decades. Misoprostol-only regimens are endorsed as a medically acceptable option by the World Health Organization and other international and national professional guidelines for abortion care. However, documented experience in the US has been limited. Here, we present a brief summary of data on misoprostol-only abortion and a sample protocol for US clinicians who wish to offer it.