BackgroundFormal education surrounding abortion care during pre-clinical years of medical school is limited and will likely decrease with the overturning of Roe v. Wade. This study describes and evaluates the impact of an original abortion didactic session implemented during the pre-clinical years of medical school.MethodsWe implemented a didactic session at the University of California Irvine outlining abortion epidemiology, pregnancy options counseling, standard abortion care, and the current legislative landscape surrounding abortion. The preclinical session also included an interactive, small group case-based discussion. Pre-session and post-session surveys were obtained to evaluate changes in participants’ knowledge and attitudes and to collect feedback for future sessions.Results92 matched pre- and post-session surveys were completed and analyzed (response rate 77%). The majority of the respondents identified themselves as more “pro-choice” compared to “pro-life” on the pre-session survey. Results reflected significantly increased comfort discussing abortion care and significantly increased knowledge about abortion prevalence and techniques after the session. Qualitative feedback was overwhelmingly positive and reflected participants’ appreciation for the focus on the medical aspects of abortion care as opposed to an ethical discussion.ConclusionsAbortion education targeted to preclinical medical students can be implemented effectively by a medical student cohort with institutional support.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12909-023-04395-x.