In this article we trace a biography of vacuum aspiration in Spain between the 1960s and 1980s. Analysing the local but transnationally connected history of vacuum aspiration during late Francoism and the democratic transition, we argue that this technology was since the mid-1960s reincarnated in mainstream medical discourse as vacuum curettage, presented as a major medical innovation in diagnosis and therapy. While abortion activists working at the end of the 1970s emphasized the group and political components of a technique they called the ‘Karman method’, doctors performing illegal abortions within the family planning network defined vacuum aspiration in terms of safety and medical innovation. As we demonstrate, this technique embodied meanings that at times overlapped, at others conflicted, contingent on whether aspirations were linked to medical innovation, pro-abortion activism, or social justice.