Objective To investigate the therapeutic efficacy of intramuscular injection of vitamin B12 and oral multivitamins in treating patients with recurrent spontaneous abortion(RSA)complicated with elevated serum homocysteine(HCY).Methods A total of 137 RSA patients with elevated HCY were selected as research subjects,and divided into injection group(intramuscular injection of vitamin B12)and oral group(oral Aleve multivitamin tablets).General data of two groups were collected,including age,the number of spontaneous abortion,serum D-dimer level.HCY level before and after treatment,the percentage of normal HCY after treatment,the time of HCY falling to normal,the use rate of low molecular weight heparin,pregnancy rate,the success rate of fetal pregnancy,the rate of holding baby and pregnancy complications were compared between two groups.Results When compared with oral group,injection group had significantly decreased HCY level(P=0.002),the increased percentage of normal HCY(P=0.042),the shortened time of HCY falling to normal(P<0.001),the increased pregnancy rate and the increased rate of holding baby(P<0.05)as well as the decreased incidence of pregnancy complications(P=0.003).Conclusion When compared with the oral multivitamins,intramuscular injection of vitamin B12 in treating RSA patients with elevated HCY can effectively reduce the serum HCY level in a short time,and improve the clinical outcomes of the patients and reduce pregnancy complications.