Background: Manual vacuum aspiration (MVA) is a widely used procedure for the management of early pregnancy loss, primarily in low resource settings. A highly successful analgesic method with few side effects is paracervical block (PCB). This study aims to evaluate the patient’s satisfaction and adverse effects associated with PCB during MVA for early pregnancy loss. Methods: This cross-sectional prospective observational study was conducted at Rajshahi Medical College Hospital, Bangladesh, from January to June 2019. Fifty-two women with early pregnancy loss were included through convenience sampling. PCB administered before MVA; pain, satisfaction, effects assessed systematically. Results: This study found that, 23.07% of patients had a just palpable uterus and tenderness in 88.5%. 73.10% patients presented with active bleeding. The cervical OS was open in 76.93% of patients and in 42.30%, the product of conception was felt. Regarding resuscitation, 73.07% required IV fluid infusion, all needed antibiotics and 23.1% required blood transfusions. Most patients (69.23%) had minimal per vaginal bleeding and the average procedure duration was 8-10 minutes (80.77%). The procedure was reported easy by 86.54% of patients, 7.7% reported discomfort and 88.46% would recommend it to others. Adverse effects included nausea in 1.92%, epigastric pain in 3.85%, and excessive bleeding in 5.77%, which was effectively controlled by pressure. Conclusions: Paracervical block is a safe, effective, and well-tolerated analgesic option for MVA in managing early pregnancy loss. Its minimal adverse effects and high patient satisfaction suggest its routine use in clinical practice.