Fetus-in-fetu is a rare congenital condition in which a malformed fetus-like structure is found in the body of its twin. We report a unique case of a male neonate with cleft palate and a fetus-like structure arising in his oral cavity. The neonate underwent emergent surgical removal of the mass immediately after delivery. Radiological and pathological studies of the resected mass provided supportive evidence for the case of an oral fetus-in-fetu. To our knowledge, there are few cases of oral fetus-in-fetu in the literature. Moreover, the presence of cleft palate in this neonate is of potential interest and clinical importance.