The incidence of intraventricular hemorrhage (IVH) in twin pregnancy infants with birthweights less than 1500 g in a 5 year period was examined retrospectively. Of the 70 infants in this birthweight category (for which IVH status was known) born at the University of Michigan Medical Center between January 1980 and December 1984, 20 had IVH (29%) (p = NS). The only significant association with IVH was respiratory distress. Presentation, route of delivery, a low 5 minute Apgar score, and time between first and second delivery were not significant factors. However, a multiple logistic regression of the infants categorized by IVH status demonstrated significant effects of twinship itself and of birth order within a given twinship. The unexpected low incidence of IVH in this high risk group suggests that better obstetric and neonatal management of low birthweight preterm twins at tertiary care centers may result in improved survival and decreased morbidity including intraventricular hemorrhage.