Objective To evaluate the sedative effect of remimazolam combined with propofol in painless abortion surgery. Methods A total of 150 patients who underwent painless abortion surgery at Department of Gynecology, Yichang Central People's Hospital from January 2023 to May 2023 were selected. According to the random number table method, they were divided into three groups (n=50): a propofol group (group P), a low‑dose remimazolam combined with propofol group (group R1P), and a high‑dose remimazolam combined with propofol group (group R2P). Group P was intravenously infused with propofol at 1‒3 mg/kg, group R1P was intravenously infused with remimazolam at 0.05 mg/kg and propofol at 1‒3 mg/kg, and group R2P received intravenous infusion of remimazolam at 0.10 mg/kg and propofol at 1‒3 mg/kg, in addition to the same other anesthesia agents in the three groups. Furthermore, the dosage of propofol, awakening time, the rate of successful sedation, and the incidence of adverse reactions (hypoxemia, hypotension, bradycardia, and hiccups) were recorded. Results Compared with group P, groups R1P and R2P showed increases in the successful sedation rate, decreases in the dosage of propofol, reduction in the awakening time, and decreases in the incidences of hypoxemia, hypotension and bradycardia (all P<0.05). Group R2P also showed lower dosages of propofol than group R1P (P<0.05), with a higher incidence of hiccups than groups R1P and P (all P<0.05). Conclusion The combination of low‑dose remimazolam and propofol is superior to propofol alone for sedation in painless abortion surgery.