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Objective: To compare the efficiency and related financial parameters of the double- and triple-marker test for the second-trimester maternal serum screening for Down′s syndrome.Methods: The serum samples were collected from the 2nd trimester pregnant women in this hospital and were examined for three biomedical markers [alpha-fetoprotein (AFP), free β-human chorionic gonadotropin (free β-hCG) and unconjugated estriol (uE3)] by TR-FIA. The pregnancy outcomes were followed up and screening efficiency calculated for double-marker (AFP+ free β-hCG) and triple-marker (AFP+ free β-hCG+uE3) test.Results: (1) A total of 4,707 serum samples of 2nd trimester pregnancy were collected in this study, of which 4,245 pregnancy outcomes got followed up by May 30, 2009, with 462 cases lost to follow-up. The follow-up rate was 90.2%. 3 cases of Down′s syndrome, 4 cases of other chromosome abnormalities and 1 case of neural tube defect (NTD) were found. There was no medically induced miscarriage by invasive tests. (2) Detection rate and false positive rate of triple marker test for Down′s syndrome screening were 66.7% and 5.26%, respectively, while those in double marker test were 33.3% and 4.01%, respectively. The detection rate of all chromosome abnormalities was 75% in triple marker test and 37.5% in double marker test. The detection rate of NTD was 100% either in double or triple marker test. (3) It costs 499,375 RMB to avoid one Down′s syndrome birth by using triple marker test and 781,200 RMB by using double marker test. Conclusion: Triple-marker test is superior to double marker test in 2nd trimester maternal serum screening for Down′s syndrome, and costs less to avoid a Down′s syndrome birth.