Conjoined twins are rare, heteropagus conjoined twins are rarer, and epigastric heteropagus conjoined twins are rarer still. It refers to unequal and asymmetrical twinning in which the dependant component (parasite) is smaller and attached to the epigastrium of the dominant component (autosite). We report 3 cases of epigastric heteropagus conjoined twinning. A review of literature is presented along with a discussion of possible etiopathogenesis.