This chapter presents a comprehensive and scientific review of craniopagus twins (CPTs). It delves into the complex embryological processes that lead to this rare condition and categorizes the different types of craniopagus fusion. The focus extends to the complexities of prenatal diagnosis and emphasizes the need for multidisciplinary collaboration in both planning and implementation of surgical separation. Advanced technological aids such as imaging techniques and rapid prototyping for surgical planning of the conjoined twins are discussed extensively. This chapter also addresses the profound psychological, ethical, and legal implications of treating CPTs. Detailed case studies are presented to illustrate the multifaceted medical, surgical, and postoperative care challenges and thus offer a comprehensive understanding of the complexities of the condition.