Fetal hydrops due to Rh (D) alloimmunization can be reversed by ultrasound-guided intravascular transfusions with improvement in perinatal morbidity and mortality. We report a case of in utero intravascular transfusion in hydropic twins which reversed all the hydropic findings within 3 days. A simple intraperitoneal transfusion was performed in each twin 2 weeks later, and only one neonatal exchange transfusion was required for the ultimate survival of both twins.