Conjoined twins are rarely encountered in the clinical practice of the anaesthetist and the issues that have to be considered in their anaesthetic management are unique and fascinating. Pygopagus are one of the rare type of conjoined twins with only a handful of cases reported in the literature. We present the case of one and half month old male pygopagus conjoined twins who were joined together dorsally in lower lumbar and sacral region and shared a single thecal sac. They were brought to our hospital for separation surgery
