This study determined the effects of twin birth on subsequent postpartum disorders, culling and reproductive performance, and its risk factors in dairy cows. Detailed data related to reproduction, health, and calving events, including dates of artificial insemination (AI) and calving, hormonal treatment prior to conception, cow parity, twin birth, retained placenta, metabolic disorders, and endometritis were collected from 1,717 individual calvings on 9 dairy farms. The incidence rate of twin birth was 3.4%. Gestation length was shorter in cows with twin birth ($270.6{pm}2.0$ days) than cows giving birth to singletons ($279.5{pm}0.2$ days, P < 0.01). The incidence of retained placenta (47.5 vs. 16.0%), metabolic disorders (18.6 vs. 3.8%) endometritis (62.7 vs. 28.2%), and culling rate (32.2 vs. 16.5%) was greater in cows with twin birth than in cows giving birth to singletons, respectively (P < 0.01). The hazard of pregnancy (adjusted hazard ratio, AHR) by 210 days in milk analyzed using Cox proportional hazards model was affected by calving season, in that the rate of pregnancy for cows calved during spring was less than for cows calved during winter (AHR = 0.80; P = 0.01); this was also true for endometritis (AHR = 0.46, P < 0.01). AHR was not affected by twin birth. Logistic analysis demonstrated that increasing the cow parity (P < 0.01) and hormonal treatment prior to conception (adjusted odds ratio, AOR = 1.84, P < 0.05) increased the risk of twin birth. These results demonstrate that twin births are responsible for severe economic losses through the increased occurrence of postpartum disorders and culling; thus, appropriate management for the deleterious impact of twin birth, and/or reducing the risk factors by herd control regarding cow parity and the use of reproductive hormones prior to conception might be necessary.