The authors present a case of a triquetrum fracture and pisiform dislocation diagnosed in the emergency department. The patient described wrist pain with no other complaints. However, after a plain radiograph in the emergency department, a minimally displaced avulsion fracture of the triquetrum and subtle pisiform dislocation was detected. The patient was placed in a forearm volar splint upon consultation with an orthopedist. Careful examination is imperative given the rarity of an associated pisiform dislocation.