A first case of newborn Tibetan macaque (Macaca thibetana) twins was observed in a free-ranging group at Huangshan, China. The female that gave birth to the twins was studied during their first 5 months post-partum, and her activity budget was compared to those of adult females with single or no offspring in order to assess her behavioral changes. Our report shows that female Tibetan macaques can produce twins, and that twins can successfully survive. The adult female with twins spent more time foraging and resting, but less time moving and engaged in other social behaviors than adult females with a single infant or no infant. Our report provides a case of successfully surviving twins in a wild environment and suggests that the mother modified her behavior patterns to adapt to the heavy burden. We conclude that both food provisioning and the mother's behavioral strategies facilitated the survivorship of twins. This expands our understanding of the reproductive biology of Tibetan macaques.