The 1990-2008 estimates for the maternal mortality associated with unsafe abortion require a re-examination. To provide the latest estimates of the mortality associated with unsafe abortion and to examine trends within the framework of new maternal mortality estimates. Extensive search of databases and websites for country- and region-specific data on unsafe abortion. Reports, papers, and websites with data on unsafe abortion incidence and mortality. Earlier published estimates for the unsafe-abortion-related mortality were recalculated by country for 1990, 1997, 2000, and 2003 to harmonize with the new maternal mortality estimates. The resulting estimates were aggregated to give subregional, regional, and global figures, including those recently estimated for 2008. In 2008, unsafe abortions accounted for an estimated 47000 maternal deaths, down from 69000 in 1990. Globally, the unsafe-abortion mortality ratio has declined from 50 in 1990 to 30 in 2008. The overall burden of unsafe abortion mortality continues to be the highest in Africa. Important gains have been made in reducing maternal deaths attributable to unsafe abortion. However, 1 in 8 maternal deaths globally and 1 in 5 maternal deaths in Eastern Africa continue to be attributable to unsafe abortion. Averting these preventable deaths can contribute to achieving Millennium Development Goal number 5 of improving maternal health. Copyright © 2011. Published by Elsevier Ireland Ltd.