Objective: This study aimed to analyze pregnancy and perinatal outcomes in singleton and twin pregnancies undergoing ultrasonography (USG)-indicated and clinically indicated cervical cerclage. Methods: The study population included pregnant women with a cervical length of < 15 mm as determined by transvaginal ultrasonography between 16 and 27 weeks of gestation or a cervix < 4 cm open as observed through USG measurement, who subsequently underwent emergency cervical cerclage. The study compared pregnancy and perinatal outcomes between the two groups. Results: A comparison of the data according to USG (n = 18, 37%) or clinical (n = 31, 63%) indication revealed that the weeks of cerclage, weeks to delivery, and duration of pregnancy were similar between the groups (p = 0.509, p = 0.095, p = 0.090, respectively). In pregnancies involving a single fetus (n = 36, 73%) and those involving two fetuses (n = 13, 27%), the week of cerclage, the week of delivery, and the duration of pregnancy exhibited no statistically significant differences (p = 0.344, p = 0.309, p = 0.762, respectively). Conclusions: In both singleton and twin pregnancies, emergency cerclage between 16 and 27 weeks of gestation in patients with cervical shortening or dehiscence has been demonstrated to prolong the gestation period under appropriate conditions by experienced specialists.