Objective :to present an updated overview of multifetal pregnancy as well as to study the problems of multifetal pregnancy in our community via a hospital-based study. Methods :data concerning maternal and neonatal adverse outcomes in multiple pregnancy was collected from feb. 2017 to jan. 2018. IBM-SPSS (version 24) was used for statistical data analysis. Results :The prevalence of multifetalprgnancy was 4.5% , Mean maternal age was 27.3 years with SD 5.9 years, and ranged from 17 to 42 years, Mean of gestational age was 31 weeks with SD 6.1 weeks, and ranged from 17 to 40 weeks, risk factors of multiple pregnancy was 17% history of ART and ovulation inducton in 53%. Only 13% had family history of multiple pregnancy and only 4% had previous history of multiple pregnancy, , 85% of the study group had a twin , 11% had a triplet and 4% had a quadriplet., that 21% had inevitable abortion, 2% had Deep venous thrombosis(DVT), 2% had threatened abortion, also 2% had missed abortion, 3% had polyhydraminos, 3% had Intrauterine fetal death(IUFD) , 27% had premature rupture of membranes(PROM), 12% had Pre_eclampsia, only 1% had eclampsia, 10% had Hyperemesis gravidarum(HEG), 2% had gestational DM, 4% had gestational hypertension , 2% had congenital anomalies and 1% had antepartum hemorrhage , 56% had CS, 23% delivered vaginally and 21% had abortion, 30% not need neonatal intensive care unit (NICU), 43% need NICU, 4% had neonatal deaths, 23% abortion and 51 % preterm baby. Conclusion :Multifetal pregnancies are associated with increased maternal and perinatal risks specially preterm delivery that increase risk of neonatal morbidity and mortality. There is a need for specialized antenatal care to reduce complications via wise used of ovulation induction , fetal reduction, single embryo transfer in case of ART .