Combined type Ⅲ Monteggia fracture dislocation and ipsilateral distal radial epiphyseal fracture is a very rare injury.Because of difficulty in performing the proper clinical evaluation of a child in an acute injury state,one of the components of this combined injury may be missed.We report a tenyear-old male child with this kind of injury where the Monteggia lesion was initially missed at the emergency department.Later we found the combined epiphyseal fracture of distal radius and Monteggia lesion in the ipsilateral side of the same limb which was managed by closed reduction and K-wire fixation.Bony union as well as wrist and elbow motion was complete 3 months after surgical intervention.