In the present study we summarized the world literature on first trimester multifetal pregnancy reduction between 1985 and 1992 and added our own experience. Our aim was to reach a comprehensive view on the survival rate of reduced high multifetal pregnancies, as the data in various studies are somewhat confusing, possibly as a result of the small number of cases. The data so gathered were classified by the number of fetuses. Of 94 triplet pregnancies reduced to twins 91.6% survived. Of 108 quadruplet pregnancies reduced to twins 92.6% survived. Of 40 quintuplet pregnancies 72.5% survived, and of 93 septuplets or more 87.1% survived. The outcome of pregnancies reduced to triplets did not differ from the outcome of pregnancies reduced to twins, with a survival rate of 85.7 and 72.5%, respectively. In our opinion, in view of the infertility history of many of these patients, the risk of pregnancy loss, the high survival rate of triplets and fetal reduction in triplet pregnancies in this group of patients may be unjustified. Accordingly, our policy in cases where the patients demand or when reduction is done early in pregnancy to reduce the triplets.