Female pygopagus twins, Gargi and Gayatri, were born with a common sacrum and a common subarachnoid space, and their vaginas and anal canals shared a common posterior wall. The circumference of union at birth was 42 cm. At 4 months with a combined weight of 7.4 kg, they were successfully separated. Details of the surgical and anaesthetic management are given and the factors contributing to our success are emphasized. The twins are now 2.5 years old and are normal except for inadequate urinary continence.