We report a case of an 18-month-old female who presented with three su
pernumerary upper limbs of varying lengths on the right side. Each lim
b had a proximal, middle, and distal segment, and an intercalated elbo
w and wrist joint. A single digit was present in the superior limb, th
ree digits in the middle limb, and two digits in the caudal-most limb.
Right plagiocephaly, congenital torticollis, scoliosis involving the
upper and mid thoracic region, and a hypoplastic right pectoralis majo
r were the other abnormal features noted. Radiography showed two scapu
lae, humerus, a single forearm bone in each limb, and rudimentary meta
carpals and phalanges. Limb duplication may rarely be encountered in p
arasitic conjoined twins. The role of mutagens, drugs, cellular contri
butions, and morphogens in the growth and differentiation of limbs has
been studied in animals. It is rather difficult to deduce the time of
action of the factors responsible for such a malformation.