ABSTRACT: INTRODUCTION: Fracture dislocations of the elbow appear extremely complex. Identification of the basic injury patterns can facilitate management. CASE PRESENTATION: A 38-year-old male motor-vehicle driver who fell on his right elbow after an accident was suffering from posterior dislocation of the elbow, without coronoid fracture, and with fracture of the radial head and olecranon, and medial collateral ligament disruption, which was not associated with any vascular or neural injury. CONCLUSION: Posterior dislocation of the elbow associated with fracture of the radial head and olecranon, and medial collateral ligament disruption may be a rare subgroup of elbow dislocation. We should pay more attention to medial collateral ligament injury with elbow dislocation.