Abstract Objective The proposed study is to evaluate the rate of Caesarean section and outcomes in twin pregnancies undergoing induction of labour, in comparison to singleton pregnancies. Design A retrospective case-matched cohort study Setting A single public hospital in Hong Kong Population or sample A total of 320 patients, comprising 160 patients with singleton pregnancies and 160 patients with twin pregnancies who underwent the induction of labour between 1 January 2012 and 31 December 2020. Methods The patients with twin pregnancies were matched with singleton pregnancies on a one-to-one basis in terms of parity , maternal age and the indication for the induction of labour. Main Outcome Measures The recorded data included the mode of delivery. The matched groups were subjected to statistical analysis, utilising the McNemar test for categorical variables and paired t-tests for continuous variables. Results The number of having lower segment caesarean section was 42/160 (26.3%) in twin pregnancies and 27/160 (16.9%) in singleton pregnancies underwent induction of labour. (OR 2.14, CI 95% 1.14 to 4.04, p = 0.024) Conclusions The failure rate of induction of labour in twin pregnancy was higher than in singleton pregnancy. Nevertheless, more than 73% of patients with twin pregnancies undergoing induction of labour had successful vaginal deliveries. Funding Nil Keywords Twin pregnancy, Induction of labour, success rate