Abstract: Objective To analyze the effect of assisted reproductive technology (ART) on maternal and neonatal outcomes of twin pregnancy. Methods Totally 348 women with twin pregnancies from Daxing Hospital of Capital Medical University (from January 2014 to December 2016) and Amcare Women's and Children's Hospital at Wanliu (from January 2016 to December 2018) were selected.According to the different ways of conception,they were divided into ART group (n=139) and spontaneous conception group (n=209).The clinical characteristics,maternal and neonatal outcomes of the two groups were compared. Results The average age of the ART group was higher than that of the spontaneous conception group (32.3±4.8) years vs (30.7±5.5) years,P=0.006,and the proportion of primipara was higher 86.3% vs 70.8%,P=0.001.The preterm birth rate in the ART group was higher than that in the spontaneous conception group 69.8% vs 56.5%,P=0.012,and the incidences of gestational diabetes mellitus (GDM)(37.4% vs 16.7%,P<0.001)and postpartum hemorrhage (15.1% vs 8.1%,P=0.041) were higher than those in the spontaneous conception group.There was no significant difference in the incidence of preeclampsia,ICP,placental abruption,placenta previa,blood transfusion and hysterectomy between the two groups (all P>0.05),and no significant difference was found in neonatal outcomes (all P>0.05). Conclusion In twin pregnancies,women conceived by assisted reproductive technology are older and have higher rate of primipara compared with those having spontaneous conception,meanwhile the incidences of preterm birth rate,GDM and postpartum hemorrhage are also higher.