Birthweight significantly influences the health and nutrition of a newborn. Low birth weight (LBW) is a global problem in both high and low income countries and it carries significant morbidity and mortality. In Nigeria, Prematurity, has been found to be a major cause of LBW. The burden of managing these patients especially those who are extremely low birth weight(<1000g) is high, due to lack of specialized and equipped newborn units, thus survival rate is still low in the country. This is a case report of an extreme low birth weight (ELBW) preterm female baby, who is a second twin, delivered at a gestational age of 23 weeks +5days, with a birth weight of 600g, and was successfully managed and discharged home after 59 days on admission. This highlights that survival rate of ELBW neonates delivered before the age of viability, can be improved even in low income countries( LICs) or Low middle income countries( LMICs) with adequate newborn care and good nursing care.