Although multiple pregnancy rate in natural conception is less than one percent, this increases significantly in assisted reproductive cycles. The number and rate of multiple pregnancies have increased over the past two decades. Aim: This study was carried out to compare safety and efficacy of multifetal pregnancy reduction by transvaginal route, using mere mechanical disruption, at an early gestational age (6 weeks – 9weeks + 6days) VS KCL injection through a transvaginal ultrasound guided approach in achieving fetal reduction and to observe the pregnancy outcome after fetal reduction using these 2 methods. Methods: This was an observational study on 50 pregnant women –with multifetal pregnancy achieved by ARTs- were recruited from the Kasr Al-ainy hospital and private infertility center (Riyadh Fertility and Reproductive Health center). Cases were randomize in to Group A :The needle was introduced into the desired gestational sac, then into the fetal cardiac region, and Group B:The injecting needle tip was introduced into the cardiac region and 0.5 ml of potassium chloride (KCL) was injected. Results: fetal reduction with “Mechanical disruption” procedure shows better outcomes compared to the “KCL injection” procedure; as it gave a higher percentage of take-home babies (75% vs. 58.33%), and less percentages of immediate loss (16.6% vs. 25%), miscarriage (5% vs. 9 %), and extreme prematurity (5.0% vs. 12.5%). Conclusion: we suggest that the early transvaginal mechanical non-KCl method is a better option for MFPR. We believe that it should be considered as the first choice modality in the majority of centers.