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All India Institute of Medical Sciences, Neurosurgery Department, New Delhi, India Fracture of the cranial bones following trauma is common. The fracture most commonly encountered in clinical practice is an undisplaced linear fracture of a skull bone or a depressed skull fracture. Compound elevated skull fracture, unlike depressed skull fracture is an extremely rare variety of post-traumatic cranial injury, seldom seen in modern clinical practice. Authors report one such rare case of compound elevated skull fracture, simulating a formal frontoparietal craniotomy, in a 20-year-old male patient following a railway accident. The mechanism of its production as well as the management of such injury is discussed. Keywords : Skull fracture, Elevated skull fracture, Head injury