Dislocation of the pisiform is a rare injury, with only few cases reported in the literature. This condition, in association with terrible triad injury of the elbow, is an even more rare occurrence. We report a case of a 51-years-old right-handed female patient who suffered from a dislocation of the left pisiform in association with terrible triad injury of the elbow, after a ground level fall. It was performed a reinsertion of the coronoid process and radial collateral ligaments with anchors, radial head arthroplasty, and closed reduction and internal fixation of the pisiform with Kirschner wire. At the end of follow-up, the patient had satisfactory range of movement of the wrist and elbow, and no residual pain. This rare injury to the wrist is demanding in diagnostics and treatment. However, with a correct diagnosis and appropriate treatment, an excellent clinical outcome can be achieved.