Throughout the nineteenth century, American physicians and scientists invoked the term “monster” in efforts to collect, classify, and theorize the bodies of infants with extreme congenital anomalies. They also marshaled new frameworks of “monstrous” development to advance claims about racial hierarchy and degeneration. Drawing on medical and scientific publications, case histories, and preserved specimen collections, this talk will examine physicians’ interest in anencephaly, a terminally severe anomaly that featured prominently in studies of medical monstrosity. “Monstrous” anencephalic bodies were linked to concepts of race through a shared framework of development: just as these fetuses reflected an arrest or deviation in the course of embryological development, allegedly “lower” races reflected an arrest or deviation in the course of human racial descent. In this, monstrosity gained new specificity as a way for Euro-American theorists to articulate the nature of racial inferiority. Physicians and scientists also employed concepts of monstrous development to describe the precise mechanism of racial degeneration. Anencephaly was cast as the embodied endpoint of such degeneration, conceptualized as a slide down a hierarchical spectrum of human racial development. Medical discourse on monstrosity intertwined with burgeoning cultural fears about white Anglo-American decline: the figure of the monster, understood as a racial “reversion” produced by white and nonwhite mothers alike, exposed critical vulnerabilities of the racial order. Here, defective reproduction was configured as a key site of cultural and racial meaning-making within nineteenth-century medical science, preceding the seminal eugenic rhetoric that would later come to pervade American science, culture, and politics.