The studies and their sequence should be carefully planned based on the type of fixation, associated anomalies and need for immediate separation. The current excellent outcomes, even in difficult cases of conjoined twinning, suggest that separation should always be considered, with rare exception. Carefully planned and rehearsed operations approached by a team of surgeons, anesthesiologists and skilled nurses should yield a high success rate in separating conjoined twins who otherwise would lead a life of ridicule and deformity.