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Introduction: Acardiac twin syndrome, a rare complication of monochorionic twin pregnancies with an incidence of 1 case in 35000 births , often results from a twin reversed arterial perfusion sequence (TRAP) where one twin is structurally and functionally abnormal, resulting in increased perinatal & neonatal mortality of both twins, increased operative interference & maternal complications. Aims and Objectives: This presentation aims to elucidate the diagnostic difficulties, management strategies and outcomes associated with acardiac twin syndrome . Materials and Methods: History, clinical examinations, prenatal investigations, pregnancy monitoring & interventions. A 20 years, Primigravida, O+ve, beta thalassaemia carrier, no other medical comorbidies, attended GOPD at 7 wks 5 days gestation for routine check up. Hb-9.4 gm/dl. Earliest USG showed single intrauterine pregnancy of 6wk 5 days. Scan at 18 wks 3 days showed singleton pregnancy with no gross congenital anomalies but polyhydramnios. Twin pregnancy with one IUFD was first observed in an USG of 24wk 3 days . Ultrasound on 28/07/24 revealed one baby with hydrops, at 30 weeks and 1 day maturity, while the other showed no cardiac activity with abnormal structures (?acardiac twins) . Blood, Urine, ECG, ECHO are within normal limit. Management and outcome: Admitted with pain abdomen at 31 wks on 3/08/24.BP-N,Spo2-95%,CBG-90mg/dl, Hb-8gm/dl, FHS- 138/min. Counselling done. Moist O2, Fluids, antibiotics, inj steroid given. Planned for VD( possibility of CS discussed).Labour monitoring done. Episiotomy given. First baby was cephalic, living, preterm with hydrops, delivered vaginally with asphyxia, but couldn?t be survived. Second baby(acardiac) delivered by breech extraction. Prophylactic inj carboprost given. No remarkable vaginal / cervical injury seen. 2 units blood transfusion done, Discharged in good condition after 48 hrs. Conclusion: This case highlights the complexities of managing a monochorionic-diamniotic twin pregnancy complicated by TRAP Sequence and acardiac twin syndrome. Early detection and careful monitoring are crucial to optimize outcomes.