Left-to-right transposition of the normally asymmetrical organs of the body is termed situs inversus. Situs inversus is a rare congenital anomaly; according to Varano and Merklin, the reported incidence is estimated at 1:5,000 to 10,000 in adults. Its etiology is obscure but it apparently does not influence normal health or life expectancy. Many cases of malignant neoplasms with situs inversus have been found in corresponding English literature, but there was no documentation of double cancer of the esophagus and stomach associated with situs inversus totalis. We present a case of double cancer of the esophagus and stomach in a 49-year-old male with situs inversus totalis. Chest X-rays and an abdominal CT scan revealed situs inversus totalis. A chest and abdominal CT scan, and gastroscopy with tissue biopsy determined esophageal and gastric cancer.