This paper will discuss twin pregnancies. Twins can be either dizygotic or monozygotic. Nowdays, the frequency of twin pregnancies is increasing. Most pregnancies start as twin pregnancies, but in the first trimester there can be a disappearance of one twin. This is also known as a vanishing twin. Pregnancy should be diagnosed in the early stage, in order to have an insight into the actual frequency of twin pregnencies and to prevent possible complications. Pregnancy monitoring is also very important and requires a special attention from healthcare professionals. Cardiotocography, ultrasound, amiocentesis, and amnioscopy are some of the methods for pregnancy monitoring. The birth of twins can be risky, but in most cases it goes smoothly. The twins pass together through the I. and III. birth phase, while they go through the phase II. separately. During the first birth period, constant monitoring with cardiotocography is important, and in the second birth period, special attention should be paid to the position of the second twin and the manner of completing the birth. Due to the overstretching of the uterus during the pregnancy there is possibility of bleeding occurring, therefore third birth period requires special supervision of the mother. The complications for mother and the newborn twins can come along with the twin pregnancies. Preterm birth, discordant growth, twin to twin transfusion syndrome (TTTS) and twin reserved arterial perfusion syndrome (TRAP) are the most common complications for the newborn twins. As for the mothers of the twins preeclampsia, gestational diabetes, inferior vena cava syndrome etc. are the most often developed complications. With her knowledge and skills, midwife provides support and a sense of security to the woman during the process of birth. Midwife assists during the examinations and actively participates in the birth process of twins. Her role contributes to the quality of the obstetric team significantly.