The frequency of multiple pregnancies with more than two fetuses has increased considerably since the introduction of methods of ovulation induction, in vitro fertilization, and embryo transfer. We have analyzed the evolution, complications, delivery and perinatal outcome of 23 triplet and 3 quadruplet pregnancies occurred during a four-year period in one medical center. The most frequent complication was preterm labor (62%). The mean gestational age at delivery was 32.5 weeks for the quadruplets and 31.5 weeks for the triplets and the mean birth weight was 1461 and 1526 for quadruplets and triplets, respectively. Perinatal mortality for the whole group was 148/1000.