A rare case of an acute open dorsal perilunate dislocation of the left wrist was encountered in a 42 year old male with the exposure of the lunate volarly. It was associated with ulnar artery injury and complete ulnar nerve palsy. It was treated by open reduction and internal fixation through dorsal and volar approaches after a thorough debridement. That was complicated with a forearm compartment syndrome which was treated by a fasciotomy. To my knowledge, this is the first reported case of a perilunate dislocation associated with ulnar artery and nerve injury.