Heteropagus, or "parasitic," twins are asymmetric conjoined twins, in which the host (autosite), is near normal and bears the parasite, which is totally dependent for growth on it. A parasitic twin who is attached to the epigastrium of the autosite is called as Epigastric heteropagus conjoined twins (EHTs) which are extremely rare. An associated congenital cardiac malformations, has been described in autosites. Here we report a rare case of epigastric heteropagus conjoined twins with cyanotic congenital heart disease (CHD) in the autosite.