RESUMO
BACKGROUND: Multifetal pregnancies are high-risk pregnancies. Coexistence of conjoint twins with multifetal pregnancies further increases the risk factor, which is already considerably high with multiple births. Assisted reproductive techniques lead to an increase in multifetal pregnancies, especially monozygotic pregnancies, which in turn lead to an increase in the rate of conjoined twins. CASE: A spontaneously achieved quadruplet pregnancy with coexisting conjoint twins has not been reported previously. We report one such case of spontaneously achieved quadruplet pregnancy with coexisting conjoined twins. CONCLUSION: Early (preferably first trimester) recognition of multifetal pregnancy, chorionicity, amnionicity and fetal malformation help in proper pregnancy management and optimizing outcome.