© 2022 Walter de Gruyter GmbH, Berlin/Boston.Objectives: The aim of the present study was to evaluate a new ultrasonographic scoring method that could predict spontaneous preterm birth (sPTB) in uncomplicated twin pregnancies during routine anomaly screening in the midtrimester. Methods: This prospective study included women with a monochorionic diamniotic (MCDA) or dichorionic diamniotic (DCDA) twin pregnancy gestational ages from 170/7 through 226/7. A new ultrasonographic score between 0 and 5 points was calculated using cervical length (CL), uterocervical angle (UCA), and cervical dilatation status during routine anomaly screening in the midtrimester. The primary outcome of the study was the prediction of sPTB < 32 and <34 gestational weeks. Results: A total of 118 pregnant women with twins were evaluated, 31 of whom delivered before 34 gestational weeks an 87 of whom delivered after 34 gestational weeks. The sensitivity and specificity values were separately calculated for scores of 3.5 and 2.5 for predicting sPTB < 32 gestational weeks. The cut-off value of 3.5 provided a sensitivity of 80% and a specificity of 82%. When the score was 2.5, the sensitivity and specificity were 86 and 71%, respectively. To determine a score for predicting sPTB < 34 gestational week cut-off value of 3.5 provided a sensitivity of 80% and a specificity of 90%. When the score value was 2.5, the sensitivity and specificity of the method were 83 and 81%, respectively. Conclusions: Our results indicated that the midtrimester new scoring is a simple technique that can be easily used as an improved tool for predicting the risk of sPTB in women with a twin pregnancy.