Shettikeri A, et al. - In twin reversed arterial perfusion (TRAP) sequence, a phenomenon seen in 1–3% of monochorionic twin pregnancies, the normal pump twin maintains its own perfusion in addition to that of its acardiac co-twin. Given the relation of TRAP with high perinatal loss, researchers conducted this study evaluating surgical techniques to interrupt the blood flow to the acardiac twin. They evaluated interstitial laser therapy of TRAP pregnancies referred over a 5-year period. During this period, a total of 18 cases of TRAP were counseled regarding fetal therapy if the situation were to deteriorate. Five couples (27.7%) opted for termination of pregnancy; of the remaining 13, 7 (53.8%) agreed to perform intervention following confirmation of a normal karyotype. Outcomes confirm the high risk of spontaneous loss in untreated pregnancies with TRAP. This is primarily due to polyhydramnios and fetal hydrops. A more favorable outcome was observed in the pregnancies that underwent interstitial laser. In experienced hands, the interstitial laser is minimally invasive, safe, and feasible.