Background: Twin pregnancy is considered as one of high risk for both mother and baby with variable incidence worldwide. Methods: This was a prospective, observational, hospital based study that was carried out in Omdurman maternity hospital during the period September 2012 to February 2013, 112 ladies with twin pregnancy and their respective babies were included in the study. Maternal and neonatal data were recorded using a specifically designed questionnaire. Data was processed and analyzed using SPSS Program. Results: The study revealed that the prevalence of twins was 3.34%, most of the women lied between the age group 23-32 years.57 (50.9%) of the women had previous history or family history of twins, the commonest antenatal complication encountered was severe urinary tract infection in 79(70.5%) followed by hyper emesis gravidarum in 52(46.4%) and anaemia in 43(38.4%). The main postpartum complication was postpartum haemorrhage in 39(34.8%). Most of the babies (81.3%) needed admission to the neonatal unit. The study revealed that 60.4% of the babies had low birth weight, prematurity was 66% among the study group. Early neonatal mortality rate was found to be 196/1000 among the study subjects. Conclusion: Twin pregnancy is a significant risk factor for maternal and perinatal morbidity and mortality in low-resource settings.