Igbo-Ora, a town in southwestern Nigeria, is renowned for exceptionally high dizygotic twin birth rates, recording approximately 45 per 1000 live births. This article explores the factors behind this unique phenomenon by critiquing the community’s perceptions and narrative of the factors responsible for the high twinning rate and comparing these perceptions with biomedical hypotheses. Drawing on 6 months of ethnographic fieldwork — participant observation, 81 semistructured interviews, and FGDs — this study documents local narratives that highlight hereditary ‘twin threads’ —; specific foods, notably Ilasa (okra-leaf soup) and cassava meals; environmental qualities of ‘air’ and ‘water’; and divine sanction as factors responsible for the incidence of twin birth in Igbo-Ora. These local narratives are analyzed against certain biomedical perspectives on maternal age and parity effects, putative genetic variants influencing gonadotrophins, and dietary phytoestrogens. The study found that the community resist single-cause explanations for the incidence of twin birth and instead articulates a complementarity of genetic, ecological, dietary, and spiritual factors. This holistic framing contrasts with and complements prevailing genetic and nutritional theories surrounding the incidence of twin birth. The article argues that future genetic and epidemiological investigations in high-twinning populations must be culturally attuned to ensure accurate phenotype definition, ethical engagement, and translational relevance.