Takayasu arteritis is a rare chronic inflammatory vascular disease involving the aorta and its major branches. During pregnancy, the disease can be life-threatening. This report describes a successful management of twin pregnancy complicated with Takayasu disease, rarely described elsewhere. A 33-year-old pregnant woman had been diagnosed with Takayasu disease since the age of 15 during a typical history and investigation. The patient underwent abdominal aortic aneurysmectomy with graft and revascularization of renal artery with saphenous vein graft before pregnancy. This pregnancy was a monochorion-diamnion twin. She was closely followed up and taken care of by a multidisciplinary approach at the high-risk antenatal clinic. A single fetal demise was detected at 20 weeks and the live fetus was diagnosed with intrauterine growth restriction at 25 weeks. Cesarean delivery was performed at 30 weeks due to severe IUGR, abnormal umbilical artery Doppler, and maternal superimposedpreeclampsia, giving birth to a healthy female baby weighing 960 gm. The case presented here implies that a successful outcome of twin pregnancy complicated with Takayasu disease is possible with multidisciplinary approach and extreme cautions.