Objective: to reveal the characteristics of perinatal outcomes after different intrauterine surgical techniques for feto-fetal transfusion syndrome. Subject and methods. During 2013—2015, the Ural Research Institute of Maternal and Infant Care, Ministry of Health of Russia, performed in utero surgical correction of feto-fetal transfusion syndrome in 69 women with monochorionic diamniotic twin pregnancy (a study group). A control group consisted of 22 women with monochorionic diamniotic twin pregnancy, who had manifestations of feto-fetal transfusion syndrome and had not undergone intrauterine surgical correction of the pathological condition. The study group was divided into three subgroups according to intrauterine surgical techniques: 1) 39 pregnant women who had undergone laser coagulation of placental anastomoses; 2) 18 pregnant women with previous septicemia; 3) 12 pregnant women who had undergone intrauterine coagulation of umbilical cord vessels. Results. Analysis of perinatal outcomes of monochorionic diamniotic twin pregnancy shows that in the group with intrauterine surgical correction of feto-fetal transfusion syndrome, the overall favorable outcome, i.e. live-birth rate, was 52.9% while in the control group this indicator was equal to 31.8%. The follow-up of infants in different age periods (early neonatality, late neonatality, and infancy) revealed that 75% (30/40) and 54.1% of the infants were survivors in Subgroups 1 and 2, respectively; all 9 live-born babies survived in Subgroup 3. In the control group, there were 6 survivors of 14 live-born infants. As compared to the control group, the study one had much more favorable results that were attributable to prolonged pregnancy, namely increases in gestational age and anthropometric parameters, a considerable decrease in the proportion of hypoxic states in twin-pregnancy fetuses undergoing intrauterine surgical interventions. Comparison of the fetal surgical interventions used indicates that the subgroup of infants undergoing laser coagulation of placental anastomoses showed the best results of correction of feto-fetal transfusion syndrome (23.1% of the pregnancies resulted in the birth of one full-term baby and 75% of the surviving babies). Umbilical cord vascular coagulation has strict limitations — the presence of the second unviable fetus. Conclusion. Timely and adequate pathogenetic therapy for feto-fetal transfusion syndrome at the intrauterine development stage could substantially improve favorable outcomes due to the reduced severity of this syndrome, pregnancy prolongation, and the less aggravated course of early and late neonatal periods.