Conjoined twinning is an anomaly which features two identical twins sharing one or more organs. The condition is very rare, with most antenatally detected cases ending in stillbirths or miscarriages. An incidence of 1:50,000–2,50,000 is described in the literature, with a 3:1 female predominance. A higher incidence has been noted in African countries and Asia. The twins are always of the same sex, but differing personalities. These cases have elicited great fascination historically, and the literature over the years has described improving outcomes. The management has to be customized on a case-by-case basis and is preferably performed at a center with prior expertise. A thorough and planned undertaking by a multidisciplinary team of experts from all relevant fields leads to successful separation with reduced mortality.