Craniopagus twins represent a rare phenomenon of congenital misfortune. Modern neurosurgical techniques have created opportunities for successful separation and the promise of a normal existence for these children, who in the past were often left as historical footnotes or put on display as oddities of nature. The authors document a brief history of conjoined twinning and discuss the modern science of craniopagus epidemiology, classification, and separation. In particular, the strategies used and the rationale for staged surgical separation are highlighted.