The intrauterine fetal death in a gemelar pregnancy is a rare complication with an incidence from 0.5 to 6.8% of all gemelar pregnancies with a conservative management for the mother and the surviving fetus. The complications are due to the passage of tromboplastic substance from the death fetus to the surviving fetus, through intravascular communications specially in monocorionic placenta producing nervous central system, kidney and skin alterations, mainly in the surviving fetus and coagulation system alterations in the mother. We present a case of a gemelar pregnancy with a fetal loss in utero with repercussions in the surviving fetus in the nervous central system. At the same time we made a literature review.