The article focuses on the extraperitoneal laparoscopic pelvic lymphadenectomy treatment for cervical cancer patients with twin pregnancy. Topics include the usefulness of the extraperitoneal route as it decreases fetal exposure to general anesthesia, the case of a 39-year-old woman carrying a monochorionic diamniotic pregnancy at 1 weeks, and the treatment given to the patient by performing extraperitoneal pelvic lymphadenectomy with bilateral access.