The incidence of multifetal pregnancies has increased significantly over the last twenty years. This trend is largely attributed to delayed childbearing and the use of assisted reproductive technologies. Compared to singleton pregnancies, multifetal pregnancies confer a greater maternal risk of obstetric complications, including hypertensive disorders of pregnancy, gestational diabetes, postpartum hemorrhage, and cesarean delivery. Multiple gestations also present increased risks of fetal and neonatal complications, particularly those related to prematurity and unequal placental sharing in monochorionic pregnancies. Early diagnosis of a multifetal pregnancy by ultrasound is crucial for accurate dating and identification of chorionicity. Antenatal care should be tailored to mitigate risks. Timing of delivery in multiple gestations requires individualized assessment based on several factors, including gestational age, chorionicity, and the presence of complications. Mode of delivery for multiple gestations depends on various factors, including gestational age, fetal presentation, and type of gestation.