Introduction: The clandestine abortions remain a major health problem in developing countries including the Central African Republic. At the main maternity hospital of Bangui in the Central African Republic, a study conducted in 2000 indicates that clandestine abortions (CAs) accounted for 43.4% of all abortions recorded in the service. The purpose of our study was to evaluate the evolution of CAs about the health care management efforts made over the last 4 years. Patients and Methods: We conducted a prospective descriptive and analytical study over a period of 4 years (from January 2016 to December 2019). This study focused on the complications of clandestine abortions that occurred during the course of our study at the HCB reference maternity hospital. Results: We identified 267 clandestine abortions for 783 spontaneous abortions. The frequency of CAs was 34.1%. The highest number of CAs was observed in patients aged between 20 and 24 years with an average age of 23.7 years. The average parity was 2.6. It appeared in our study that students were the most represented (40.8%). Rescuers were the most incriminated (29.2%) in clandestine abortion (CA). Infectious complications predominated in (79.1%) of cases. Antibiotic therapy was almost systematic (96.6%). Laparotomy was performed in (38.9%) cases. The proportion of deceased women who had a pregnancy of more than 12 weeks was higher with a statistically significant difference (p 0.001). Conclusion: Abortion affects all women regardless of age, parity, marital status and socio-economic status.