Twinning is a multifactorial trait influenced by both genetic and environmental factors that can negatively impact animal welfare and economic sustainability on commercial dairy operations. To date, using genetic selection as a tool for reducing twinning rates on commercial dairies has been proposed, but not yet implemented. In response to this market need, Zoetis (Kalamazoo, MI, USA) has developed a genomic prediction for twin pregnancies, and included it in a comprehensive multitrait selection index. The objectives of this study were to (1) describe a genetic evaluation for twinning in Holstein cattle, (2) demonstrate the efficacy of the predictions, (3) propose strategies to reduce twin pregnancies using this information. Data were retrieved from commercial dairies and provided directly by producers upon obtaining their permission. The twin pregnancies trait (TWIN) was defined as a pregnancy resulting in birth or abortion of twin calves, classified as a binary (0,1) event, and analysed using a threshold animal model. Predictions for a subset of cows were compared to their on-farm twin records. The heritability for twin pregnancies was 0.088, and genomic predicted transmitting abilities ((g)PTAs) ranged from −7.45–20.79. Genetic correlations between TWIN and other traits were low, meaning that improvement for TWIN will not negatively impact improvement for other traits. TWIN was effectively demonstrated to identify cows most and least likely to experience a twin pregnancy in a given lactation, regardless of reproductive protocol used. Effective inclusion of the prediction in a multitrait selection index offers producers a comprehensive tool to inform selection and management decisions. When combined with sound management practices, this presents a compelling opportunity for dairy producers to proactively reduce the incidence of twin pregnancies on commercial dairy operations.