Twin pregnancies differ from singleton pregnancies by the average duration of the pregnancy and the prevalence of complications during pregnancies and during a labor. Vaginal delivery of twins, and one of them is in breech presentation, is not common occurrence but it is certainly present in opstetric practice. This retrospective study was conducted at the Clinical hospital „Sveti Duh“ from January 1, 2005 to December 31, 2018. The study involved women who delivered twins by vaginally, and one of twins or both were in breech presentation. There were 45 vaginal deliveries of twins in beech presentation during observed period. There were 40 deliveries where first twin was in head presentation and second twin in breech presentation, furthermore 2 deliveries where first twin was in breech and second in head presentation and 3 deliveries where both twins were in breech presentation. Maternal demographic parametars and perinatal outcome of newborns depending on the mode of delivery used were observed. Maternal parametars that were observed include: maternal age, parity, the course od labor (spontaneous, induced) and the incidence of the episiotomy. In perinatal outcome of newborns, birth weight and lenght of newborns, gestational age and an Apgar score at 1 and 5 minutes after delivery of both twins were observed. The results showed that twins delivered by mode of Thiessen (minimally assisted breech delivery) and Vermelin (spontaneous vaginal breech delivery without procedures) had a better perinatal outcome. More than 65% of observed twin pregnancies were terminated and 6 of a total of 90 newborns (6,67%) were tranferred to nenatal intensive care unit (NICU). This results indicate that the assisted delivery tehnique has an impact on perinatal outcome of newborns delivered by vaginally and that newborns delivered with less- traumatizing method of assistance have better perinatal outcome.