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Introduction: The combination of both collateral ligaments injury in the elbow without fractures or dislocations is not reported in the literature., Case Presentation: a case report of rare acute combined collateral ligaments injury of the elbow was treated surgically by repairing both collateral ligament complexes with two different approaches., Clinical Discussion: Clinical examination at 3 months showed a stable elbow with a flexion arc from 0 to 140. 10 degrees residual varus laxity was observed. Pronation and supination were unrestricted. The patient experienced mild pain and was able to do push up and was completely satisfied with the result., Conclusion: The case presented is the first case presented in the literature with acute combined and isolated collateral ligaments injury of the elbow. Based on the clinical result obtained. We propose acute surgical approach of both collateral ligaments for such types of injury., Competing Interests: Declaration of competing interest The author and co-author have no conflict of interest to disclose. Source of support in the form of grants, equipment, or other items: “none”., (Copyright © 2022. Published by Elsevier Ltd.)