Looking like it needs braces, twinspot wrasses have a pair of teeth that stick out of their mouth. These shovel into the sand, uncovering their prey hiding underneath. Twinspot wrasses have large molar-like teeth in their throat called pharyngeal teeth. These teeth crush up the hard-shelled animals they eat like shrimp, clams, crabs, snails and urchins.

Twinspot wrasses have three different life phases and look completely different in each one. Juveniles give this wrasse its name. It looks like the first half of the body is from one fish and the second half is from another. The first half of the fish is white with black spots. The spots are dense closest to the head and completely fade out moving toward the tail. The second half of the fish has white scales outlined in black. There are two orange spots at the top. On top of the orange spots are two black spots outlined in white. The dorsal fin or fin on the back is white with black spots and has a white outer outline. The same is true for the anal fin or fin on the bottom near the tail and the caudal fin or tail.

Twinspot wrasse live in sandy or rubbly patches on outer reef flats, lagoon reefs and seaward reefs at depths of 7 to 100 feet (2 to 30 m). Juveniles live in shallow tide pools. They are diurnal or active during the day. At night, the smaller twinspots sleep underneath coral rubble or sand. The larger ones rest inside caves or under coral ledges.