Jeremy Irons portrays the dual roles of Beverly and Elliot Mantle, the identical twin gynecologists at the center of the film.
Geneviève Bujold plays Claire Niveau, a famous actress and love interest of one of the Mantle twins.
Heidi von Palleske takes on the role of Cary, a patient of the Mantle twins who becomes involved in their complex relationship.
Barbara Gordon portrays Danuta, another patient of the Mantle twins who plays a significant role in their lives.
Shirley Douglas plays Laura, a colleague of the Mantle twins who is caught up in their unraveling lives.
Stephen Lack portrays Wolleck / Anders Wolleck, a patient of the Mantle twins who adds to the layers of the story.
Nick Nichols takes on the role of Leo, a character who interacts with the Mantle twins during their descent into darkness.
Lynne Cormack portrays Arlene, a character whose presence influences the lives of the Mantle twins.
Damir Andrei plays Birchall, a supporting character in the film who becomes entangled in the twins' turbulent relationship.
Miriam Newhouse portrays Mrs. Bookman, a character connected to the world of the Mantle twins.
David Hughes takes on the role of the Superintendent, a character who becomes involved in the aftermath of the twins' actions.
Richard W. Farrell plays the Dean of Medicine, a character who represents the authority figures in the twins' professional world.
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