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Conjoined twins are rare variants of monozygotic twins. There are many types of conjoined twins, and they are usually classified at the point at which they are fused. Our patient fitted into a thoraco-omphalopagus type, where there was fusion of the thorax as well as mid-trunk [3]. The most common type of renal fusion anomaly is the horseshoe kidney. It consists of 2 distinct functioning kidneys on each side of the midline, and they are more likely to be connected at the lower poles [4]. We describe here a 30 year-old patient who presented to the antenatal clinic of Chris Hani Baragwanath hospital in Soweto, South Africa at 34+ weeks gestation. Foetal magnetic resonance imaging revealed thoraco-omphalopagus conjoined twins with complex thoracic and abdominal structures, including a horseshoe kidney that was confirmed on post-natal computed tomography.

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