Shaken Baby Syndrome is a serious type of physical abuse, mainly involving children younger than 6 months of age. Since first described in 1971, the syndrome has appeared in increasing numbers of publications that discuss the pathogenesis, clinical findings, variability and poor outcome. This article discusses four pairs of twins treated for Shaken Baby Syndrome within an 11-month period at the same German hospital. Of these infants, five were severely affected and two died. In one family, both of the twins repeatedly suffered injury from being shaken. The article notes that: (1) three of the four cases involved children of premature births; because twins are more likely to be born prematurely, the risk factor "prematurity" and the possible risk factor twin "status" overlap; (2) sociodemographic characteristics appeared to be of no importance; (3) twin status could influence the quality of some psychological aspects; and (4) a possible factor promoting the formation of a stressful situation and familial dysfunction was the parents' social isolation resulting from the increased demands of time and energy to care for twins. Table, references