BACKGROUND: Previous systematic reviews have concluded that medical termination of pregnancy (TOP) provided by non-physician providers may be as effective and safe as when provided by physicians. Medical treatment of incomplete miscarriage by non-physicians, and treated women's acceptability with non-physician providers of TOP has not previously been reviewed. OBJECTIVE: To review the effectiveness, safety and acceptability of non-physician provision of first trimester medical TOP including medical treatment for incomplete miscarriage. SEARCH STRATEGY AND SELECTION CRITERIA: A search strategy using appropriate medical subject headings was developed. Electronic databases (PubMed, Popline, Cochrane, CINAHL, Embase, and ClinicalTrials. gov) were searched from inception through April 2016. Randomized controlled trials and comparative observational studies were included. DATA COLLECTION AND ANALYSIS: Meta-analyses were performed for included randomized controlled trials regarding the outcomes effectiveness and acceptability to women. Certainty of evidence was established using the GRADE approach assessing study limitations, consistency of effect, imprecision, indirectness and publication bias. MAIN RESULTS: Six papers were included. Medical TOP and medical treatment of incomplete miscarriage is probably equally effective provided by non-physician providers as by physicians (RR 1.00; 95% CI 0.99 to 1.01). Women's acceptability reported as overall satisfaction with allocated provider is probably equally high between groups (RR 1.00; 95% CI 1.00 to 1.01). CONCLUSIONS: Medical TOP and medical treatment of incomplete miscarrage provided by trained non-physician providers is probably equally as effective and acceptable to women as when provided by physicians.