Twin reversed arterial perfusion (TRAP), a rare condition (0.3:10,000) that occurs in monochorionic twin pregnancies, with the coexistence of a normal “pump twin” and an acardiac twin. The acardiac twin is parasitic, using an anomalous reversal of umbilical arterial flow. This anastomosis occurs in the 3rd–4th week of gestation, and the acardiac twin puts the pump fetus at risk of high-output cardiac failure. The pump twin has a mortality rate of up to 55%. Antenatal ultrasound recognition in the first trimester Doppler confirmation of the diagnosis of TRAP sequence in twin pregnancies aids in proper prenatal diagnosis. Presented is a 26-year-old woman, gravida para, who came to our hospital at 19th gestational week (GW). The first ultrasound showed a twin monochorionic/diamniotic pregnancy, with one normally developed fetus and an atypical mass without a heart. The patient was previously monitored elsewhere, but TRAP syndrome wasn't identified. We followed her until the 26th week, and she was later sent to a tertiary center for further conservative treatment in the absence of operative treatment in our country. The patient gave birth via C-section in the 32nd gestation week. The normal twin was born in good condition and was sent home after a few weeks.