Transvaginal ultrasound-guided pregnancy reduction (TUGR) is a procedure described for the management of twins post-fixation in the horse. Success rates are often disappointing but reported to be more favourable for bilaterally-situated twins, and when intervention takes place before day 35 of gestation. This study aimed to determine whether stabbing the embryo/fetus rather than aspirating conceptus fluids improved the likelihood of success, suggests that TUGR is not the method of choice for reducing > day 45 twins. Four pregnancy losses were recorded 1-7 months post-TUGR (4/38: 10.5%) and, while it is tempting to attribute the losses to TUGR, this rate of late gestation pregnancy loss is normal. We conclude that TUGR by fetal stabbing does not offer significant advantages over fluid aspiration.However, TUGR should be performed before day 35 of gestation and considered primarily a salvage procedure to be used when re-breeding is not a viable alternative.