Objectives: To describe the use of 3D models and expanded reality (XR) for surgical planning discussion since prenatal.Methods: At 23 weeks of gestation 3D ultrasound (US) and magnetic resonance imaging (MRI) were acquired for better understand of the pathology status and surgical planning.Therefore, a multidisciplinary discussion for postnatal separation of craniopagus, with professionals in different regions in Brazil, was initiated.The surgery was planned to occur in stages, using before and after each procedure, 3D models and XR.Results: After birth, the children were completely separated into 9 stages, ending at 4 years of life.On the first stage 3D models provided clear understanding of brain structures and using XR it was possible to amplify the discussion with experts around the world.With the success of the first stage the same procedure was done for the next ones.It was possible to prevent some adverse effects as the models were used as a training methodology.Conclusions: The use of 3D models and XR in pre-surgical planning was a fundamental tool in surgical strategy and localisation for the surgeon, being a situation in which the anatomy is completely divergent from normal standards.XR has also been an important mark, assisting and allowing the surgeon to find the best surgical approach and discussion with other experts worldwide.