To estimate the likelihood of cesarean delivery and length of labor in twin pregnancies undergoing induction of labor as compared with singleton pregnancies. This was a retrospective cohort study of 100 patients with twin pregnancy in one maternal-fetal medicine practice undergoing induction of labor from 2005 to 2012. The control group was 100 randomly selected patients in the same practice with a singleton pregnancy undergoing induction of labor over the same time period. The primary outcome was mode of delivery (vaginal or cesarean). The likelihood of cesarean delivery did not differ between the groups (19% in twins compared with 21% in singletons, P=.724) nor did the time from induction to vaginal delivery (median and interquartile time 9.7 [5.5-12.5] hours in twins compared with 10.4 [6.6, 14.1] hours in singletons, P=.255). Results were not different when we looked at nulliparous patients only or multiparous patients only. On adjusted analysis of risk factors for cesarean delivery in patients undergoing induction, twin pregnancy was not independently associated with cesarean delivery. Patients with twin pregnancies undergoing induction of labor have a similar risk of cesarean delivery and a similar length of labor as patients with singleton pregnancies undergoing induction of labor. II.