This chapter mainly focuses on the delivery of twins. When a woman carries twins, the pregnancy is deemed high risk and additional regular antenatal care and ultrasound scanning is necessary to optimize the health of the mother and babies. Risks during pregnancy include fetal growth restriction, preterm delivery, anemia, preeclampsia, and postpartum hemorrhage. The steps of delivery of twins are discussed with the help of 12 well-colored clinical images, which are very helpful for students and readers. Management of the second stage of labor and internal podalic version are also covered in this chapter.