Abortion is a common reproductive health procedure worldwide, but it can have significant effects on the uterus. Particularly in young adult women understanding these effects is critical to preventing complications and safeguarding reproductive health. This study aimed to evaluate the effects of abortion on the uterus of adult females aged 19–25. A cross-sectional study was conducted among 50 women who had undergone abortion. Ultrasonographic examination was performed to assess uterine structure, presence of fluid in the pouch of Douglas (POD), endometrial changes, and other abnormalities. Data were analyzed using frequency distribution, chi-square tests, and associations between age, uterine effects, clinical impressions, and implications were examined. The most common uterine effects observed were retroverted non-gravid uterus with fluid in the POD (22%), fluid in POD alone (18%), and anteverted bulky uterus with acystic mass (18%). Ultrasound impressions included hormonal-induced dysfunctional uterine bleeding (22%), ectopic pregnancy (18%), and retained products of conception (18%). The major implications for uterine health were heavy menstrual bleeding affecting ovulation timing (22%), severe bleeding threatening fertility and life (18%), and incomplete abortion potentially causing infertility (18%). Age was not significantly associated with the effects of abortion (p=0.785). However, strong associations were found between specific uterine effects and both clinical impressions and implications (p<0.001), indicating predictable patterns of complications based on ultrasonographic findings. Abortion can lead to structural and functional changes in the uterus, including fluid accumulation, uterine distortion, and menstrual or fertility disturbances. Timely intervention, careful monitoring, and safe abortion practices are essential to minimize complications and preserve reproductive health in young adult women.