two conjoined strawberries
Sean Cate
Sean Cate
June 8, 2024 ·  4 min read

What Happens If One Conjoined Twin Dies, But The Other Continues Living?

Conjoined twins are both rare and fascinating. If you don’t know, conjoined twins are when two individuals are physically connected at birth. This unique condition occurs once in every 200,000 births and often comes with significant medical complications. Conjoined twins can share organs and bodily systems, making their separation and survival a complex and delicate matter. This article explores what happens if one conjoined twin dies while the other continues living, drawing on historical examples and medical insights to understand the implications.

Understanding Conjoined Twins

Conjoined twins X-ray
Image Credit: Wikimedia Commons

Conjoined twins come from a single fertilized egg that fails to completely separate into two embryos. The degree of connection and shared organs can vary, leading to different types of conjoined twins:

  • Thoracopagus Twins: These twins are joined at the upper part of the ribcage and often share a heart and circulatory system. This is the most common type, making separation challenging and survival without the other twin difficult.
  • Omphalopagus Twins: Connected from the breastbone to the waist, these twins typically share a gastrointestinal system, liver, and sometimes reproductive organs.
  • Craniopagus Twins: Only 2% of conjoined twins fall into this category, where they are joined at the cranium. Their survival post-separation depends heavily on the extent of their connection and the possibility of surgical intervention.

Historically, most conjoined twins end up being stillborn, and those who survive birth face high mortality rates within the first 24 hours. Modern medicine has enabled successful separations, but these cases remain rare and complex.

Read More: Newborn Twins Denied Insurance for Life-Saving Treatment of Fatal Genetic Disorder

What Happens When One Twin Dies?

two headed historical sculpture
Image Credit: Shutterstock

If one twin passes, the fate of the surviving twin depends largely on the shared systems and the cause of the other twin’s death.

When one twin dies, the surviving twin is at risk of sepsis, a severe infection that if left untreated can lead to organ failure and death. If the twins share vital organs, such as the heart or liver, the surviving twin’s chances of survival diminish rapidly.

Dr. Eric Stauch explains that if one twin’s heart stops, the other twin will lose blood rapidly, and there are only a few hours to perform life-saving surgery. The surgery required is highly complex and requires immediate medical intervention.

Historical Examples

Chang and Eng Bunker
Image Credit: Wikimedia Commons

Chang and Eng Bunker are the most famous conjoined twins, and were joined at the sternum and shared a liver. When Chang died of a blood clot, Eng followed three hours later due to complications from the shared circulatory system. This case underscores the critical nature of shared vital systems and the rapid decline that follows a conjoined twin’s death.1

c, born in 1908 and joined at the pelvis, were a well-known musical act. When Daisy passed away from the flu, Violet survived only a few days before dying, likely due to the combined effects of grief and infection from her sister’s body.

Simplicio and Lucio Godina
Image Credit: Wikimedia Commons

Simplicio and Lucio Godina were connected by skin and cartilage at the pelvis. Lucio died from rheumatic fever, and Simplicio did survive the emergency separation. Unforunately they died 12 days later from spinal meningitis. This case highlights the difficulty of survival even after successful separation.

Millie and Christine McKoy
Image Credit: Wikimedia Commons

Millie and Christine McKoy were born into slavery and exhibited worldwide as curiosities. The pair were conjoined at the pelvis. Both sisters died of tuberculosis in 1912, with Millie passing first and Christine following 12 hours later. This case demonstrates how shared health conditions can simultaneously affect conjoined twins.

Read More: Conjoined twins Physically, Belle and Abby were connected from birth, but surgery permanently changed everything

Modern Cases and Medical Advances

Conjoined twins, who came from Larkana, are being treated at surgical unit at National Institute for Child Health (NICH) on October 08, 2010 in Karachi, Pakistan
Conjoined twins, who came from Larkana, are being treated at surgical unit at National Institute for Child Health (NICH) on October 08, 2010 in Karachi, Pakistan. Image Credit: Shutterstock

Today, the separation of conjoined twins has become more feasible, but it’s still fraught with risks. For example, Gabby and Michaela Garcia were separated at eight months old, having shared legs, kidneys, a bladder, and intestines. While Gabby survived, Michaela died at 13 due to complications from their condition.2 Gabby’s story has been shared on social media to help highlight both the medical advancements and the emotional aftermath of such surgeries.


Painting of conjoined twins
Image Credit: Wikimedia Commons

The survival of one conjoined twin after the death of the other is rare and highly dependent on the specifics of their connection and shared systems. Even with immediate medical intervention, it is often still not sufficient to save the other twin due to the rapid onset of sepsis and other complications. Historical and modern cases both give insight into the challenges conjoined twins face and how the medical community’s ongoing efforts have improved their outcomes. Despite advancements, the reality remains that the death of one conjoined twin often heralds the imminent loss of the other.

Read More: 12 Years Ago They Were Called The World’s Most Beautiful Twins – Now Look At Them


  1. Here’s What Happens In The Tragic Case That One Conjoined Twin Dies.” Ranker. Jodi Smith. June 14, 2019.
  2. Conjoined twin recalls sister’s death: ‘I feel like I can channel her’.” NY Post. Samantha Ibrahim. December 28, 2021.