INTRODUCTION: Intracapsular and extracapsular hip fractures are common amongst elderly patients but simultaneous intracapsular and extracapsular hip fractures are rare. CASE PRESENTATION: We present the case of an elderly woman who sustained simultaneous intracapsular and extracapsular hip fractures and describe the complications which ensued following fixation. CONCLUSION: Concomitant ipsilateral intracapsular and extracapsular femoral neck fracture is an uncommon injury pattern. It occurs most commonly in osteoporotic patients with low energy falls. Close examination of radiographs must be made to ensure that more subtle fractures are not overlooked and the injury managed appropriately. If doubt exists on initial radiographs further imaging should be considered.