Elbow fractures with dislocation are a challenge to treat and are associated with poor clinical outcomes as outlined in the literature. The terrible triad of the elbow is a combination of radial head fracture, coronoid process fracture, injury to collateral ligaments, and posterior dislocation of the elbow. The involvement of osseous and chondral supports around the elbow are considered as the variants in the terrible triad of elbow. We are reporting a brief review on such terrible triad variance of the elbow including cases who underwent management at our institute and a glimpse on other globally reported cases of similar variance. As it is necessary for the treating clinicians to get well-versed with such injuries, which can be easily missed during evaluation. The data available on these entities are limited and there is a further need to educate the clinicians regarding the same and its implications on the patients.