Abstract : Conjoined twins are a rare case. Thoraco-omphalopagus was one of the most common types of conjoined twins. The management of thoracic defects presents a great challenge, especially since no standard procedures for chest reconstructions are available in the center. In this case report, we describe the successful reconstruction of a thoracic defect in thoraco-omphalopagus 17 months years old conjoined twin with titanium mini-plate and wire stabilization. The twins are now 2.5 years old, are healthy and have normal growth, and are under follow-up.