Despite the abortion of the Medical Termination of Pregnancy (MTP) Act more than 48 years ago, utilization of safe abortion services still remains inadequate among the community. A retrospective clinic based study was carried out among women who came for abortion and sterilization services at 23 Non-Governmental Organisation Clinics from four states namely Rajasthan, Uttar Pradesh, West Bengal and New Delhi. The aim of the study is to assess the abortion and sterilization profile along with temporal change across selected states in India and also to find out some selected associated factors in relation to the abortion and sterilization prevalence. Total 66,143 women underwent abortion and 32,162 women underwent sterilization in two years. The status of total abortion has significantly decreased and sterilization has increased over the period of time. The frequency of abortion and sterilization services was highest among the women up to the age of 30 years. Most of the abortion (2018-62.5%; 2019 48.7%) and sterilization (2018-74.8%, 2019-63.2%) were availed by women belonging to low socio-economic groups (Rs.10,000/- per month). Hindu clients sought total abortion and sterilization services in higher proportion as compared to Muslim women. 55% of women who underwent abortion already had 1-2 children. In terms of sterilization 57.5% in 2018 and 52.2% in 2019 underwent sterilization. More than 50% of the women had adopted sterilization until they had at least 3-4 children. Women need to be aware about the MTP Act and her rights about the abortion and family planning.