Fetus papyraceus is a rare condition occurring in both monochorionic and dichorionic multiple gestations. Associated with the case presented were two interesting and uncommon findings: velamentous insertion of the umbilical cord of the blighted fetus and a congenital abnormality of the surviving fetus. This case is the first known intrauterine monitoring of a pregnancy involving a fetus papyraceus with serial plasma estriol and human placenta lactogen determinations.