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Capo d'Orlando has a twin city relationship with the City of Fremantle in Western Australia, established due to the cultural and historical links between the cities, and to maintain family associations, trade and tourism.
Links have been forged with Liederkranz Oberensingen, a German male choir from Pontypridd's twin town, Nürtingen.
Gouesnou is twinned with the town of Brecon in Powys, south Wales enabling cultural exchanges to take place between these two Celtic regions.
On 9 June 2012 members of a Halhul based music band played at the Hennebont cultural center in an attempt to receive a stance as Twin city with it.
With the Providence-Niquinohomo Sister City Project he had been to Nicaragua many times where the project built a health center and a school, and he twice served on medical teams in Guatemala.
It is hoped that tourism will increase after the efforts of Sedbergh to find a twin town were featured in a BBC documentary, The Town That Wants A Twin, during January 2005 (the winning town – despite rumours of a rigged election – was Zreče in north eastern Slovenia).
The island is twinned with Carloforte, in the Sardinian San Pietro Island, which was also populated with Genoese from Tunisian Tabarka.