Objective: To compare the efficacy and safety of ERTT to cerclage in triplet pregnancy. Material and Methods: In this retrospective study, files of 266 patients were examined. Eligible patients managed by ERTT (n=120) were allocated into study group while patients managed by cerclage (n=121) were allocated into control group. Embryo reduction was done by oocyte aspiration needle before 10 th week. Cerclage was done at 14-16 weeks. Obstetrical and neonatal adverse outcomes were assessed in both groups. Results: One hundred and twenty cases were allocated in cerclage (control) group, 121 cases were allocated in ERTT (study) group. There was significant difference between both groups regarding abortion rate (P-value=0.002), delivery time (P-value=0.0001), gestational age at time of delivery (P-value=0.0001) and mode of delivery (P-value=0.0002). There was significant difference between both groups regarding fetal birth weight (P-value=0.0002), overall neonatal complications (P value 0.009) and need of NICU (P=value 0.0003). Conclusion:Embryo reduction to twins (ERTT) procedures improved obstetrical and neonatal outcomes in triplet pregnancies compared to conservative management with cerclage procedure.