Premature xiphoomphalopagus conjoined twins were successfully separated at 7 days of age. The total body weight of the twins before separation was 3502 g. One twin had persistent patent ductus arteriosus and signs of cardiac failure at 4 days of age, This was managed with indomethacin. Thirty-six hours later the second twin became anuric, necessitating early emergency separation, The twins were joined from the lower sternum to the infraumbilical area, The liver was fused, but there was no major vascular connection. There were no other major anomalies, The babies stood the procedure well and were healthy at follow-up 8 months after separation.