Background: Manual vacuum aspiration (MVA) is a valuable technique for uterine evacuation for early pregnancy loss and post-abortion care, especially in situations where portability, low equipment needs and the avoidance of general anaesthetic are beneficial. Objective: To describe the volume of MVA procedures, indications, patient characteristics and documented complications at Madonna University Teaching Hospital (MUTH), Elele, Rivers State, Nigeria. Methods: This was a descriptive retrospective study, where the records of women who had MVA in the Department of Obstetrics and Gynaecology were reviewed during the study period (2013-2023). Structured proforma was used for the extraction of sociodemographic, obstetric and procedural variables. Frequencies, percentages, means and standard deviations and medians and interquartile ranges were reported. The prevalence of MVA was determined by dividing the number of MVA procedures by the number of gynaecology visits in the same period, and then multiplying by 100. Results: 173 MVA procedures were documented in 983 gynaecology visits, resulting in a prevalence of 17.6% at the institution. Most patients were aged 20–34 years (71.1%), married (81.5%) and had secondary education (84.4%). The majority of procedures were carried out prior to 13 weeks' gestation (74.6%) and by medical officers (83.8%). The most common indication was incomplete miscarriage (161, 93.1%) followed by missed miscarriage (6, 3.5%), retained products of conception (4, 2.3%) and other indications (2, 1.2%). Five adverse outcomes were documented: uterine synechia in three patients (1.7%) and post procedure vaginal discharge in two patients (1.2%). The mean estimated blood loss was 133.3 ± 102.6 mL, with five patients (2.9%) receiving one unit of blood. The median length of hospital stay was 2 days (IQR 1–3) with 47.4% having a 1 day stay. Conclusion: MVA was used in the majority of cases of incomplete miscarriage accounting for 17.6% of gynaecology visits at MUTH. Blood loss, documented complications and hospital stay were minor, and most procedures were performed in the first trimester by medical officers.