Thermal management in some small chemical reactors is essential to achieve a final high-quality product and heat sinks can play a remarkable role in dissipating heat from such systems. In this regard, this study attends to evaluate the conjugate heat transfer problem in a heat sink equipped by twisted elliptical tubes (TETs). The effects of significant parameters such as Reynolds number (Re=250, 350, 500, 700 and 950) and twist ratio (TR=2.5, 5 and 10) on hydrothermal and thermodynamics performance of the novel heat sink are investigated. The swirling flow is the main reason of fluid particles migration from hot surface to cold one and vice versa, leading a better heat transfer occurs at the expense of not significant pressure loss augmentation. The results revealed that the TETs are responsible of more wall temperature uniformity and avoids generating hot spots. Compared with plain elliptical tubes, the presence of TETs inside heat sink improves the heat transfer rate and enlarges the pressure drop by 1.08-2.03 times and by 1.02-1.92 times, respectively. In addition, the TETs decrease the entropy generation rate inside heat sink and the best value of second law efficiency is 25%, detected at TR=2.5 and Re=250.