The paper reports on the trends of induced abortion in Italy since its legalization in 1978. Data collected through the national surveillance system show that the abortion rates and ratios in Italy, after an initial increase, have been stable in the last four years, and are comparable to those of other European countries. Italian women seeking abortion, however, are generally older and more frequently married and parous than in most other western countries. The data on abortion services and procedures show a slow improvement with increasing use of local rather than general anaesthesia, suction rather than surgical curettage, and outpatient rather than inpatient admissions. Post-abortion complications are infrequent and there have been no cases of death from legal abortion. The paper attempts to analyse the effect of legal abortion on fertility and on other maternal and child health indices, reaching tentative conclusions on the contribution of the legalization of abortion to the improvement of reproductive health. Uneven availability of abortion services, however, is currently a major problem; in many of the less developed areas of the country, it is estimated that as many as 50% of abortions are still performed outside the legal abortion service network.