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Acardiac fetus in triplet pregnancy is very rare condition including fatal congenital anomaly that only occurs within monochoronic multiple gestations. It has been reported the normal “pump” fetus paradoxically perfuse the recipient “perfused” fetus through placental vascular anastomosis. The perfused fetus displays severe and lethal anomalies, including acardia and acephalus. The pump fetus may also develop cardiac failure because of its expanded cardiac demand result in high mortality. We report a case of acardiac fetus in spontaneous triplet pregnancy diagnosed by antenatal ultrasonography and spontaneous cessation of umbilical blood flow to acardiac fetus with a brief review of the literature.