Abstract: Objective: To investigate the risk factors of pregnancy-induced hypertension in twin pregnancies and its influence on pregnancy outcome. Methods: A retrospective study of 130 pregnant women with twin pregnancies admitted from July 2019 to July 2023 was conducted,42 pregnant women with pregnancy-induced hypertension were selected as the observation group,and 88 healthy pregnant women with twin pregnancies during the same period were selected as the control group.The methods of delivery,adverse pregnancy outcomes and neonatal complications were compared between two groups,and the risk factors of hypertension were analyzed by logistic regression analysis. Results: The rates of cesarean section,adverse pregnancy outcome and neonatal complications in the observation group were higher than those in control group(P<0.05).The results of univariate analysis showed that the differences of distribution of hypertension in twin pregnancies among older pregnancy,pre-pregnancy body mass index(BMI),gestational body mass increase(GWG),family history of pregnancy-induced hypertension and gestational diabetes mellitus were statistically significant(P<0.05 to P<0.01).The results of multivariate logistic regression analysis showed that the advanced pregnancy,high pre-pregnancy BMI,family history of pregnancy-induced hypertension and gestational diabetes mellitus were the independent risk factors of adverse pregnancy outcomes(P<0.05 to P<0.01). Conclusions: The risk of cesarean section,pregnancy complications and adverse pregnancy outcomes in hypertensive twins is higher.The advanced pregnancy,high BMI before pregnancy,family history of pregnancy-induced hypertension and gestational diabetes mellitus were the independent risk factors of twin pregnancy complicated with pregnancy-induced hypertension.