Objective: This study aims to provide insight into the use, acceptability and outcome of a large group of women who self-managed medical abortion. Design: Retrospective cohort study. Setting: Self-managed abortion worldwide. Population/Sample: 30344 women who completed the follow up from of the telemedical abortion service Women on Web from January 2009 till January 2020. Methods: Analyses of the evaluation forms, binary logistic regressions were performed to test the association between year and outcomes for the total sample. Main outcome measures: Demographic information including age, economic situation, country of living,knowledge about abortion pills and acceptability. Rate of complete abortions, surgical interventions, ongoing pregnancies, blood transfusions per year. Results: 30344 women from 183 different countries completed the follow-up evaluation. In total 26076 women reported taking the medical abortion pills, of which 1.5% reported an ongoing pregnancy, 10.2% a surgical intervention, and 0.6% a blood transfusion. 99% found it to be an acceptable method. 35% found it difficult to make a donation for the service and 8.5% received the service for free. 59.2% reported that they knew about medical abortion before finding Women on Web. We found a significant increase in complete abortions in 2019 (OR= 1.92; 95% CI: 1.59 – 2.31), and decrease in surgical interventions (OR= 0.49; 95%CI: 0.40 – 0.60) compared to 2009. Conclusion: The findings of the outcomes of the 26076 self-managed abortions in this study are in line with previous research , suggesting medical abortion through telemedicine is safe, effective and highly acceptable to women.