Encephalocele is neural tube defect characterized by failure of the surface ectoderm to separate from the neuroectoderm. This leads to a bony defect in the skull table, which allows herniation of the meninges or brain tissue.1,2 To report case of 30 years old gravida 5 para 3 abortion 1 lady admitted with diagnosis of twin pregnancy and one of the twin with neural tube defect, delivered one health neonate and other with encephalocele. Conclusion folic acid supplementation and/or food fortification for all reproductive age groups will reduce incidence and recurrence of neural tube defect according to the level of the risk they have.