Objective To explore the predictive effect of ultrasound measurement of amniotic fluid index (AFI) combined with cervical length (CL) on premature rupture of membranes in twin pregnant women.Methods The data of 112 pregnant women with high risk of premature rupture of membranes who came to the hospital for pregnancy test from January 2016 to July 2019 were retrospectively analyzed, recorded as the high-risk group, and retrospective analysis the data of 96 healthy twin-gestational pregnant women in the same period of pregnancy test, recorded as the healthy group. The chorionic and amniotic types were compared between the two groups; the AFI and CL measured by ultrasound were compared between the high-risk group and the healthy group; the AFI and CL measured by ultrasound in pregnant women with premature rupture of membranes and those without premature rupture of membranes were compared; the efficacy of ultrasound measurement of AFI and CL in predicting premature rupture of membranes in high-risk pregnant women with twin pregnancy were analyzed.Results There were no significant difference in the incidence of complications between the two groups (P > 0.05), and the maximum vertical depth of amniotic fluid in each amnion sac in the high-risk group was higher than that in the healthy group (P < 0.05). Ultrasound measurement of AFI were higher and CL were lower in the high-risk group than those in the healthy group (P < 0.05). The incidence of premature rupture of membranes of pregnant women in the high-risk group was 18.75%, the incidence of premature rupture of membranes was higher than that of healthy group (P < 0.05), AFI in ultrasound measurement of the incidence were higher than that in non-occurrence in the high-risk group (P < 0.05), and CL were lower than that in non-occurrence (P < 0.05). The optimal cutoff points for AFI and CL were 31.42 cm and 1.97 cm, AFI combined with CL had the highest sensitivity, specificity, and area under the curve (AUC), which were 80.95% (95% CI: 0.746, 0.859), 85.71% (95% CI: 0.768, 0.917) and 0.839 (95% CI: 0.751, 0.896), respectively.Conclusion The AFI of high-risk premature rupture of membranes in twin pregnancy is higher than that in non-occurrence, and the CL is lower than that in non-occurrence. Ultrasound measurement of AFI and CL can predict the risk of premature rupture of membranes in high-risk pregnant women with twin pregnancy, and the effectiveness of ultrasound measurement for AFI and CL in predicting premature rupture of membranes in high-risk pregnant women with twin pregnancy is satisfactory.