A 44-year-old man presented with an unusually colourful and complex form of delusional misidentification. He demonstrated Fregoli syndrome, environmental reduplication and the delusional belief that he and a female friend had been incorporated into the same body. This latter phenomenon has not been described before and adds a new dimension to the rich variety of these syndromes. It is suggested that the term ‘delusional hermaphroditism’ be used to describe this form of delusional misidentification.