A 44-year-old multigravida woman visited Jeju National University Hospital at 10.2 weeks of pregnancy because of old age. She had a history of autoimmune thyroiditis on medication.
The initial ultrasonography showed weird extremities of the fetus. After that, the clinician diagnosed a conjoined twin with hydrops: one head, one heart, one liver, four arms, and four legs.
After a thorough consultation with the patient and her husband, we decided to terminate the pregnancy.
Gross examination of the abortus revealed the top of the head down to the belly button, facing each other (cephalopagus).

Keywords: Conjoined twins, Cephalopagus