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Abstract Background Polymelia or congenital duplication of the lower limb is a rare occurrence. This congenital duplication when occurring in the region of the buttocks is known as pygomelia. Its appearance can even mimic a human tail or pseudotail. Case presentation A 22-year-old primigravida posted for emergency caesarean section was found to have a tail-like structure attached to her lower back. Pre-operative imaging of that appendage to rule out spinal dysraphism was not done due to the need of emergency surgery and pregnant status of the patient. The patient received general anaesthesia for surgery, and in the follow-up, X-ray imaging was done which showed a hemipelvis and a femur bone in that appendage confirming the diagnosis of pygomelia. Conclusions In a rare occurrence of pygomelia, the exact nature can be identified by various imaging modalities. General anaesthesia was a safe choice in such a patient presenting for emergency caesarean section.