Background: One of the key challenges regarding the managment of twins involves choosing the optimal mode of delivery, which is strongly influenced by the final presentation of both fetuses. In cases of vertex-nonvertex pregnancies attempting the trial of vaginal delivery, external cephalic version (ECV) is one of the possible management options. Objectives: The main objective of this review was to collect and summarize available data in terms of the application of ECV in the population of nonvertex second twins. Search Strategy: Using the PRISMA guidelines, different databases (PubMed/MEDLINE, SCOPUS, COCHRANE) were searched. Selection Criteria: English-language original research studies. Data Collection and Analysis: Out of 260 articles retrieved, 10 were subjected to the final analysis in terms of success rates, modes of delivery, and adverse outcomes. Main Results: The total number of ECVs was 289, with the overall success rate of 64.4%. In the group of successful versions, vertex vaginal delivery was achieved in 171 cases (91.9%). The incidence of adverse maternal and neonatal outcomes was low. Conclusions: Based on the series of articles, ECV seems to be a reasonable option of management in nonvertex second twins. However, due to the actual low number of existing studies, their retrospective nature, and questionable methodology, it is impossible to make any strong conclusions. Further research, especially including randomized studies, is needed to determine the application of ECV in this specific population.