Objectives: This study aimed to examine trends and factors associated with severe physical and psychological consequences following induced abortion among women in the Republic of Korea. Methods: An online survey was conducted of adolescent and adult Korean women aged 13 to 64 years, termed the 2022 Sex and Reproductive Health Survey. Respondents who reported a history of induced abortion were analyzed. Logistic regression models that accounted forindividual risk factors were fitted to calculate adjusted odds ratios (aOR). Results: The prevalence of induced abortion was 20.1% (914 of 4,552 respondents). The mostfrequent indications for abortion were social reasons, and across all periods, approximately half of the women or more reported non-medical challenges at the time of their most recentabortion. Severe physical and psychological sequelae after abortion increased 5-fold from 1980–1992 to 2013–2022. Among those whose most recent abortion occurred in 2003 or later, the risk of severe psychological sequelae was higher in 2013–2022, after the Korean Constitutional Court upheld the existing criminal codes, than in 2003–2012 (aOR, 2.31; 95% confidence interval, 1.09–4.91). Conclusion In the absence of institutionalized safe and respectful abortion services, severe physical and psychological sequelae among women who underwent induced abortionwere more likely to occur. These findings highlight the importance of safe, affordable,nondiscriminatory, and respectful abortion care.