Conjoined twins represent a rare form of incomplete embryonic separation. They 
are classified into eight different subtypes, with 18% representing pyopagus 
conjoints. History is scattered with accounts of the various types of conjoints 
and it is only recently that strategies have been devised to enable surgical 
separation of such twins. It is estimated that approximately 20 cases of 
separation of pyopagus twins have been performed. We provide a historical look 
at pyopagus conjoint twins and report our neurosurgical experience of 
Australasia's first separation of pyopagus twin girls.