Background: Although congenital anomalies are higher in twins than in singletons but the incidence of congenital indirect inguinal hernia with umbilical hernia in twins on the same side is extremely rare condition and is unusual. Although it is accepted as developmental anomaly, genetic factors cannot be excluded due to probability of existence in siblings. Case Report: One year old Monozygotic identical twins presented with swelling on the left side of the groin and swelling in the umbilical region since birth. Birth history –full term normal vaginal delivery. Left groin swelling was non tender, and used to increase when the child cried, extended from groin up to base of scrotum and was reducible in both the twins. Umbilical swelling was non tender, and used to increase when the child cried & was reducible in both. Conclusion: Inguinal  hernia in twins are extremely rare, as there are only a few cases on record. Little is known about its etiology, and prevalence, owing to the difficulties in tracing  the twins with hernia. It needs extensive further study involving  a wider study group and inclusion of  genetic factors  to find out prevelance & cause. 

Keywords: Congenital Inguinal Hernia, Genetic Factors,  Identical Twins