Research conducted over the last few decades has revealed an association between induced abortion history and substance abuse. The experience of induced abortion may be associated with psychological discomfort in some women and substance use offers a convenient remedy for alleviating the negative emotions without the necessity of disclosing the source of the discomfort. On the other hand, many characteristics related to the choice to abort are also systematically related to the likelihood of using substances (e.g., relationship difficulties, pre-existing emotional problems, a tendency to engage in risk-taking behavior, etc.) and the correlations observed in the literature may be due to the presence of uncontrolled third variables. Therefore, the general purpose of this review is to critically evaluate the available evidence linking induced abortion and substance abuse with sensitivity to the contextual complexity of both variables. Specific objectives include the following: 1) provision of an overview of substance use disorders in women, 2) review of evidence for a causal model, highlighting methodological deficiencies in the published literature, 3) identification of process mechanisms (direct and indirect) through which induced abortion may enhance risk for substance abuse, 4) provision of recommendations for further research, and 5) consideration of practice implications of the available findings.