Background: Twin pregnancy is considered as a high-risk pregnancy due to associated high maternal and perinatal morbidity mortality in comparison with singleton pregnancy. The objectives of this study were to study the maternal and perinatal complications in twin pregnancies. To find out various factors that contribute to adverse perinatal outcome.Methods: This retrospective study was conducted at Kempegowda Institute of Medical Sciences Hospital, Bengaluru. 92 women with twin pregnancies admitted in KIMS Hospital from September 2014 to September 2018, both booked and referred patients were studied. Individual patient parameters like age, parity, gestational age, mode of delivery, maternal complications were tabulated. Neonatal morbidity and mortality were noted, data thus obtained was analysed and results studied.Results: In the study the incidence of twin pregnancies was more in second gravida (53%). 72% of the patients were admitted between 28-36 weeks of gestation with preterm labour (23%) as the main cause for admission. Anaemia (8.69%), hypertensive disorders of pregnancies (17.39%), PPROM (21%), single foetal demise (5%) and IUGR (5.4%) were the antenatal complications observed. Out of the 92 patients, 29 (35.4%) patients delivered by vaginal route whereas 53 (64.6%) had to undergo C-section. DCDA twin constituted 66% of twins in the study and mal presentation was the commonest indication for caesarean section (50%). Among the 164 babies out of 92 twin pregnancies 8 babies were still born and 12 babies died by the end of one week due to complications related to prematurity like hyaline membrane disease, IVH.Conclusions: Early detection of twin pregnancies and proper antenatal care reduces both maternal and perinatal complication thereby improving maternal and perinatal outcome.