Safina Namukwaya delivered a boy and a girl via caesarean at a fertility centre in the capital, Kampala.
Ms Namukwaya, who is is one of the oldest women to give birth, told local media it was a "miracle".
The hospital congratulated her, saying it is more than a "medical success; it's about the strength and resilience of the human spirit".
Dr Edward Tamale Sali, a fertility specialist at the Women's Hospital International and Fertility Centre (WHI&FC), told BBC the mother used a donor egg and her partner's sperm for the in-vitro fertilisation (IVF) procedure.
The babies were born prematurely at 31 weeks and placed in incubators. Dr Sali says they are currently "stable".
In 2019, a 73-year-old Indian woman gave birth to twins following IVF treatment.We've achieved the extraordinary - delivering twins to Africa's oldest mother aged 70!" the WHI&FC posted on its Facebook page.
Ms Namukwaya told Uganda's Daily Monitor newspaper that her pregnancy had been difficult as her partner abandoned her when he realised she was going to have twins.
"Men don't like to be told that you are carrying more than one child. Ever since I was admitted here, my man has never showed up," she said.
This is Ms Namukwaya's second delivery in three years. She gave birth to a baby girl in 2020.
She said she had wanted to have children after she was mocked for being childless.
"I looked after people's children and saw them grow up and leave me alone. I wondered who would take care of me when I grow old," she is quoted as saying.
Typically women go through menopause between the ages of 45 and 55. Fertility drops around this time but advances in medicine have made it possible for them to give birth
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