This paper reported the nursing experience of thoracoabdominal conjoined twins accompanied by congenital heart disease of one infant undergoing separation operation. Nursing points：refined managements were implemented after preoperative multidisciplinary joint simulation exercise and making personalized anesthesia plan to ensure the safety，such as hump position placement to support the joint part，multi-mode accurate temperature control，safe transition of operation before and after separation，infection prevention. The total operation time was 180 minutes，and the separation time for conjoined children was 11 minutes，the Apgar score of 1～5 minute was 9～10. After operation，the twins were sent to NICU for further treatment and nursing. After separation Twin A had some cardiac insufficiency symptom such as labored breathing and so on.We considered the pulmonary hyperaemia due to patent ductus arteriosus（PDA），so PDA ligation was performed on the 7th day after separation and postoperative oxygenation was improved gradually. Twin A had regular heartbeat without chest tightness and shortness of breath， and was discharged 40 days after separation. Twin A had pulmonary valve stenosis and underwent long-term corrective heart surgery. Twin B recovered and was discharged on the 8th day afters eparation.