Aim:Rachiphagus is a rare congenital anomaly where conjoined twins are fused at the vertebral column’s midline. When one of the twins is malformed, it is referred to as a parasitic twin. The term \"parasitic twin\" also encompasses cases involving extra-limbs or limb-like structures. Despite ongoing research, the underlying causes of this condition still remain unknown.Material and Methods:This is a comprehensive review of the literature and meta-analyses of the previously published cases with a case report. A literature search was done in English language in PubMed and Semantic –Scholar from 1952 to 2023. All articles and cases with excess legs or masses attached to the back of the spine were reviewed and analysed.Results:This study included 65 cases of rachipagus anomaly. Females 37 (56,9%) were affected more than males 28 (43,1%). The low limbs were in 41 (63,1%) cases, followed by rudimental limbs and mass in 15 (23,1%) cases, upper limbs were in 8 (12,3%) cases and rudimental upper and low limbs were in 1 (1,5%) case. In majority of cases, accessory limb or mass were attached at lumbosacral region, 27 (41,5%), followed by 12 (18,5%) cases at lumbar region, 7 (10,8%) were at thoracolumbar region, 5 (7,7%) were at sacral and other regions. More than half of the cases 34 (52%) were in Asian countries, followed by 24 (37%) cases in Africa.Conclusion:Rachipagus parasitic twin is a congenital abnormality that develops during embryogenesis and exists at birth with structural deformities of the spine and additional limb / limb like mass. In this article we present a new case of rachipagus with fully developed leg and literature review.