The incidence of twin and higher-order multiple gestations has increased significantly over the past 15 years primarily because of the availability and increased use of ovulation-inducing drugs and newly developed assisted reproductive technologies. Physicians now must deal with a previously unknown type of multiple gestation, that is, the iatrogenic multiple pregnancy. The most significant and common complication of multiple pregnancy is preterm labor resulting in preterm delivery. Perinatal morbidity and mortality are affected by gestational age and weight at delivery as well as by the number of fetuses. Patient education, risk assessment, serial cervical evaluation by manual or transvaginal ultrasound examinations, specialized antepartum clinics will be use to prevent preterm birth in multiple gestations.