The Ohio town of Twinsburg hosts the largest gathering of twins in the world at the annual Twins Festival - and there were plenty of double takes this year.
Identical wins Phil and Doug Malm married identical twins Jena and Jill back in 1993. Every year the couples celebrate their anniversaries at the event. Both couples have one child and they all live under one roof in the same house in Idaho.
Phil and Doug met Jena and Jill Lassen at the festival in 1991 and were immediately drawn to one another. At the next year's celebration the men took to a stage, grabbing a microphone each to publicly propose to their identical girlfriends. A year later they married on the same platform.
Speaking in 1993, Phil said: "People don't understand why we want to live together. It's just that twin bonding thing that we have no problem with."
Phil and Jena have a son, Tim, and Doug and Jill have a daughter, Rylie. Although the children are categorically cousins, they are siblings genetically.
The Malm family is not the only example of twins married to another set of identical twins at the event, the Daily Mail reports.
Genetically identical sisters Melanie and Rachel married Nathan and Scott - also twins - after spotting them at the same time while walking down a hallway together.
Twinsburg was given its name by identical twins Moses and Andrew Wilcox, who in 1819 bought 4,000 acres of land where the town now stands and donated $20 towards the building of a school on the condition that the settlement - previously known as Millsville - was renamed.