INTRODUCTION: To describe the perinatal outcomes in triplet pregnancies in a contemporary cohort. Our hypothesis is that triplet pregnancies that have either poor obstetrical history or maternal medical conditions will have increased perinatal morbidity and mortality. METHODS: Triplet pregnancies were identified from searches in multiple hospital, during the time period of 2007 to 2014. We identified 91 triplet pregnancies and excluded of 9 (due to reduction or fetal loss). Numerous maternal variables were assessed including maternal medical and obstetric history as were neonatal outcomes. The indications for delivery were evaluated and classified as maternal, placental, or fetal. Correlation and univariate regression were used to evaluate relationships. RESULTS: 82 triplet pregnancies were identified with 246 babies. Median gestational age was 33.57 (3.54) weeks and average birth weight was 1726 g. There were 12 perinatal deaths. Prior preterm birth and nulliparity did have a negative impact on the gestational age at delivery (P=.016). Pregnancy complications included preterm labor (64.6%), hypertension (46.3%), diabetes (29%), post-partum hemorrhage (9.7%), and blood transfusion (8.5%). Maternal medical history did not impact gestational age at birth. The NICU admission rate was 78%. 47 triplets were diagnosed with a congenital anomaly. Respiratory distress syndrome occurred in 40.7%. Indication for delivery was 60% maternal, 11% fetal, 11% placental with 18% scheduled deliveries. CONCLUSION: This large retrospective study describes the morbidity and mortality for both triplets and their mothers. It shows that prior obstetric history and nulliparity are pertinent to pregnancy outcome. This cohort study provides valuable information in preconception counseling for patients considering ART.