Acardiac twinning, a rare congenital anomaly of monozygotic twin pregnancy, often results from abnormal placental anastomosis. This leads to reverse arterial perfusion with complex pathophysiology. Among the twin, acardiac twin is one of the twins that fails to develop head, arms and heart and gets its entire blood supply from structurally normal pump twin. The term reversed perfusion is used to describe this condition because blood enters the acephalic twin through umbilical artery and exit through umbilical vein which is opposite to the normal supply. The acardiac twin loses direct vascular connection with placental villi and receives its entire blood supply from pump twin. Here we are presenting a primigravida of 26 weeks with  monochorionic diamniotic twin gestation. One of the twins was acardiac acephalous  and the other pump twin  with hydrops.