Twin-to-twin transfusion syndrome (TTTS) is a severe disease which develops in 10 to 15 percent of monochorionic twin pregnancies. Placental anastomoses between the two fetuses and subsequent unidirectional blood flow from the donor to the recipient are supposed as the main pathophysiology of TTTS. Without proper management, the mortality of TTTS reaches 80 to 100%. We report a case of twin-to-twin transfusion syndrome which showed resolution by serial amnioreduction, but developed a severe hydropic change in the recipient in the third trimester.