The short-term outcomes of 29 multiple pregnancies delivered at Westmead Hospital between 20 and 28 weeks' gestation, during a 5-year period are reported. The earliest gestation at which there was a survivor was 24 weeks. The overall survival rate was 25%. Of deaths, 11.1% occurred in the delivery suite, 85.2% in the neonatal period with a further 3.7% in the postneonatal period in hospital. The outcomes for second twins were generally poor. Of survivors at 12 months, 44% were judged to have a major impairment. Extremely preterm multiple pregnancies have a high mortality and morbidity rate.