Elbow fracture dislocation is a complex injury and may be more problematic if it is misdiagnosed. The preoperative radiographs should be carefully evaluated to recognize all lesions that may occur in elbow fracture dislocations. Evaluations must include X–rays, CT scan and 3D reconstruction if available. These injuries can be classified in five categories: (1) elbow dislocation with radial head fracture, (2) elbow dislocation with anteromedial coronoid fracture (varus posteromedial instability), (3) elbow dislocation with radial head and coronoid fracture (terrible triad injury), (4) anterior elbow dislocation with proximal ulna fracture (transolecranon), and (5) posterior elbow dislocation with proximal ulna fracture (monteggia lesion). Clear definition of injury is the key factor in the treatment strategy. Elbow fracture dislocations have specific components and each components should be addressed in order to achieve a stable elbow.