In May 2018, the Irish electorate voted to remove from the Constitution one of the most restrictive abortion bans in the world. This referendum followed 35 years of legal cases, human rights advocacy, feminist activism and governmental and parliamentary processes. The reframing of abortion as an issue of women's health rather than foetal rights was crucial to the success of law reform efforts. The new law, enacted in 2018, provides for access to abortion on a woman's request up to 12 weeks of pregnancy and in situations of risk to the life or of serious harm to the health of the pregnant woman and fatal foetal anomaly thereafter. Abortion is now broadly accessible in Ireland; however, continued advocacy is needed to ensure that the state meets international human rights standards and that access to abortion care and abortion rights is fully secured within the law. •Framing abortion as a women's health issue was important for successful law reform.•Human rights advocacy was critical in maintaining political pressure for law reform.•Healthcare providers had a significant influence on public opinion and politicians.•Abortion care is now broadly accessible in Ireland, although challenges remain.•Data collection will be crucial to inform further legal and policy reforms.•Law reform was the result of many years of advocacy, and of a range of advocacy strategies.