Conjoined twin is one of the rarest variant of monozygotic pregnancy occurring due to partial division of the embryonic disc after the 13th–15th  day of conception. We report a case of thoracoparaomphalopagus conjoined twin delivered vaginally to a 30 year old pregnant woman who came to emergency labour room with labour pain.She neither was ANC registered nor got her ultrasound done.Post–partum hemorrhage and other complications of unexpectedly delivery of conjoined twin was averted with meticulous delivery techniques.We want to conclude that thoracoparaomphalopagus conjoint twin is one of the rarest form of twin gestation. These mothers have great possibility of suffering from trauma and atonic post–partum hemorrhage.Such cases should be delivered preferably at tertiary care centres with all facilities available for saving maternal life.Obstetrics ultrasound at earliest before 20 weeks of pregnancy is mandatory to detect these anomalies and terminate then immediately to avoid further maternal complications.