Peri-lunate and lunate dislocations are the result of traumatic disruption of the ligaments and capsular attachments that stabilize the carpus. They are commonly missed on initial presentation, and a delay in diagnosis can have a detrimental effect on patient outcome. A heightened alert must also exist for the concomitant diagnosis of acute carpal tunnel syndrome. Urgent stabilization of the wrist should be carried out, and the patient should be aware that this injury often results in stiffness and degenerative arthritis.