Twin pregnancy is a type of multiple birth in which the mother gives birth to two babies of the same pregnancy. It usually results from the fertilization of two separate eggs and rarely from a single fertilized egg. Its magnitude generally increases and varies according to human populations. The anatomical and physiological changes in twin pregnancy differ from those in single pregnancy. As a result, it is associated with an increased risk of maternal and fetal complications in developed and developing countries. This is probably worse in sub-Saharan Africa, where the quality and access to health facilities are questionable and poverty is deeply rooted. In addition to the high morbidities in the mother, the fetus and the newborn, twin pregnancy causes more deaths in the mother, developing the fetus and the babies compared to the single delivery. Despite its clinical and public importance, studies on the results of twin deliveries and associated maternal complications are limited to a few university hospitals in Ethiopia. It is therefore very important to have a baseline study on this issue in western Ethiopia.