Anaesthesia for the separation of conjoined twins requires a well-prepared, multidisciplinary team. Each patient for surgery is different and the extent of organ sharing and coexisting anomalies must be determined before surgery so that problems can be anticipated. We report our experience of the anaesthetic management for the separation of six sets of conjoined twins. Anaesthesia and surgery were prolonged, massive blood loss and transfusion, hypothermia, electrolyte imbalance and infection being the main perioperative problems encountered.