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- In the Asgard Saga of Saint Seiya (anime only), there's Syd and Bud, twins Separated at Birth, since in Asgard having twins was a bad omen. Syd was the lucky twin, being raised by his parents and having a good life, and Bud was the unlucky one, being a Street Urchin. When Polaris Hilda reunited their God Warriors, Syd and Bud finally get together, but Syd was the "official one" (God Warrior Mizar Zeta) and Bud was the "shadow one" (God Warrior Alcor Zeta). Always jealous of his twin's luck, Bud became the Evil Twin, but later he changed his ways after Syd sacrificed his life to save Bud's, while also giving him a heartbreaking speech where he explained that he had always known about Bud and was always sad and frustrated over being unable to help him.
- Fai D. Flowright from Tsubasa -RESERVoir CHRoNiCLE-. In the manga it's revealed further in the plot that Fai isn't his real name, but his dead twin's name. In his kingdom, having twins was considered a curse that would harm the country and it's people. After their parents died Fai and Yui's Uncle (the Emperor of the kingdom) told the twins that they could either kill one of them off, or live together and be unhappy, because only if the twins are unhappy could the country prosper. The twins, refusing to harm one another, were thrown into a giant pit reserved for bodies of sinners and criminals. Yui was stuck down in the pit trying to climb the walls with stocking up dead bodies to stand on, while Fai was locked in a tower rising from the middle of the pit; together, but separated. They were never given food or anything else, but their magic kept them alive and young... and miserable. Until at least a decade later when one twin dies and the other gets free, both with a help of an outside interference ... right before their kingdom is completely destroyed anyway, because, turns out, the Emperor wasn't quite right in the head.
- In Shaman King there's Hao Asakura, one of the founder of Asakura clan and one of the most powerful members of the clan; however, his desire to avenge his mother's death and his growing hatred of humans made him evil and was stopped in two lives. His second reencarnation was along his twin brother Yoh; knowing Hao was in this world again, the grandfather of the twins (Yohmei) attempt to kill both children, but since the old man really didn't want to do it, he hesitated for a second... then Hao saw the opening and escaped with the Spirit of Fire to be raised by one of his minions and various years later, joining to a new Shaman King competition after failed in his past two lives.
- The story of the birth of Ram and Rem in Re:Zero refers to the belief from Japanese folklore, as their oni's people must symbolize medieval Japan and Japanese demons in particular. And so, in the people of these girls it was customary to kill the born twins, as it was considered a bad omen, and because very often the twins shared horns for two, because of what they had more weaker abilities than their other tribesmen. However, Ram is a very powerful mage, so powerful that she is considered incredibly talented, so the girls manage to survive.. And ironically, all their people are killed after 10 years.
- In Finder, Ascians view twins as such a crime against nature that both are killed at birth.
- In The Ear, the Eye and the Arm, the main characters visit Resthaven, an idyllic City in a Bottle that preserves a traditional lifestyle — which happens to include killing the younger member of any set of twins. One villager argues that the visitors can't pick out the parts of their culture that they find objectionable and enjoy the rest, so they promptly escape with the twin that would have died.
- In The Giver, when twins are born, the smaller of the two is promptly Released to Elsewhere. When Jonas sees his father euthanise an infant simply because it didn't match their quota for births, it drives home the scope of the Industrialized Evil that maintains their Crapsaccharine World and he immediately makes plans to escape.
- Things Fall Apart: The Igbo people of Umofia believe twins to be a divine curse, and leave both children out in the surrounding forest to die. Some of the characters question the practice, but keep their doubts to themselves.
- Animorphs: Although only discussed in one book, the Yeerks have some problems with Twins. Visser Three's twin brother is deemed "Lesser" as part of his numerical designation. His ostrization from Yeerk Society is due mostly to his brother being a complete dick though.
- In the Secret Histories series, Eddie learns that this is the basis of a deal with an Eldritch Abomination that powers the Drood family's magic torcs and instant Powered Armor: every Drood is born with a twin, which is promptly absorbed by the Heart to create their torc. He destroys and replaces the Heart via a deal with a more friendly Eldritch Abomination who doesn't demand human sacrifice.
- In Split Heirs by Esther Friesner and Lawrence Watt-Evans, twins and other multiple births are regarded as a bad sign, so when a queen gives birth to triplets she secretly has two of the children taken away and raises the remaining one as her only son. Fate reunites the siblings when they're older and Hilarity Ensues.
- Wolves of the Calla: Almost all births in the town of Calla Bryn Sturgis are twins. The titular Wolves ride out of Thunderclap roughly every twenty-three years and kidnap one of each pair of the town's children. Months later, they are returned via train, "roont", deformed into Dumb Muscle Empty Shells that painfully grow until they die young. The purpose of this operation is revealed as The Crimson King harvesting the innate material responsible for Twin Telepathy to feed it to powerful psychics to enhance their abilities he is utilizing to destroy the Dark Tower.
- In King Solomon's Mines, this turns out to be the custom of Kukuanas. Twala, the evil king, was supposed to be killed at birth, but was saved by his mother to usurp the throne once he grew up. Umbopa, the heroes' companion, turns out to be the son of the murdered brother, come to reclaim his kingdom
- Played (and also kind of subverted) with Bridget from Guilty Gear games, appearing since X2. In the series, the androgynous character was born male with a twin brother in a village where the birth of same-gender twins is considered bad luck; therefore, his family named and raised him as a girl to protect him. When Bridget grows up, he decides to prove himself as a bounty hunter to show people that he was not cursed.
- Orc culture in Arcanum contains a variant of this, according to the manual. Twin births are a more common event for orcs than for humans, but triplets are seen as an unnecessary burden, as the mother, with her two breasts and arms, is seen as only being capable of raising two children at once. The solution to the problem is for the father to pick the weakest looking newborn and eat it, in celebration of his own fertility.
- In Fatal Frame II: Crimson Butterfly, Minakami Village had the ten year annual Crimson Sacrifice Ritual, where one twin had to strangle the other to death in order to keep the Hellgate beneath the village sealed. After a failure that caused the entire village's destruction, the restless ghosts of the inhabitants try and force the protagonist to do the same to her own twin.
- When the Sonozaki twins were born in Higurashi: When They Cry this was meant to occur. Their grandmother ultimately didn't kill them, however the youngest was sent away. To make matters complicated, Shion and Mion often did Twin Switches as children. One day they did it at the wrong time and were permanently switched, due to the heir being given an "oni" tattoo on her back. Thus, the girl known as "Mion" was really born "Shion", the younger sister who wasn't killed at birth. No one besides them know of the switch.
- In Unsounded's Gefendur faith twins are bought from their parents at birth and raised apart from society before the youngest is poisoned and eaten by the clergy, state officials and anyone with enough money to pay at one of two annual events.
- In various aboriginal tribes around the world, especially in Africa, having twins was a sign of not just bad omen, twins were (and still today are) considered the same human disease as malformed babies, so the children must be expelled from the tribe or killed, depending on the culture they born. Sometimes the shamans or wizards of the tribe are the ones who reject babies, but sometimes, the same parents don't want the babies. Sadly, this happens a lot until today in Madagascar where twin babies are usually abandoned and killed because of black magic superstitions.
- A Body Horror example is the "Vanishing Twin Syndrome" or "Fetal Resorption", in which one of the twins is condemned to death... in mother's womb, being assimilated by the survivor twin. The most fitted (and horrible) example in fiction is Stephen King's The Dark Half.
- Even when not necessarily has to be condemned at birth as most of the cases, there's the "Twinless Twin", a term for those surviving twins that felt the loss of his sibling for the rest of their lives, even when the death was in the womb or when they were babies. The Other Wiki has a list of famous cases, being some notable ones Elvis Presley and Philip K. Dick, and even having its own trope here.
- In 1800s Japan, it's rooted in the superstition that a demon had replicated the real baby and was in the process of trying to take its place-although perhaps it was only a more socially acceptable way for impoverished families to justify getting rid of the two extra mouths to feed. There are quite a few tales of the spirits of twins left in the wilderness to die coming back as yokai or vengeful ghosts (yurei/onryo).
- During the Middle Ages (in Europe), there was a common superstition that multiple births meant the mother had been unfaithful to her husband. That might be a milder form of this trope.