Background Vessel collision induces blunt and sharp force traumas to aquatic animals and is a leading anthropogenic impact affecting cetaceans worldwide. Vessel collision is an important threat affecting vulnerable coastal cetaceans such as the Indo-Pacific humpback dolphins (Sousa chinensis) which reside in coastal waters of Hong Kong amongst heavy marine traffic. Case presentation A severely injured subadult S. chinensis was sighted in the waters off southwestern Hong Kong with four gaping incision wounds on its dorsum. It was in poor body condition and seemed unable to use the fluke effectively. The deepest wound located at the caudal peduncle near the base of the fluke and exposed the underlying fractured caudal vertebrae. The dolphin was monitored in the field over three weeks and eventually captured for medical intervention as veterinary assessment indicated progressive and life-threatening deterioration. During rehabilitation, the dolphin demonstrated initial signs of improvement over the first 36 hours as supported by diagnostic tests but then deteriorated rapidly. It was humanely euthanised after three days of rehabilitation. Postmortem investigation was carried out using virtopsy (postmortem computed tomography and magnetic resonance imaging) and conventional necropsy, with special attention to the traumatic musculoskeletal injuries caused by vessel collision and also revealed acute gastrointestinal compromise and respiratory disease that further hampered the rehabilitation. Conclusion In cetaceans, the prognosis for recovery from injuries caused by vessel collision depends on the extent, location, and gravity of the injuries (i.e., superficial, deep, penetrating, blunt vs. sharp, fresh vs. septic), as well as the health status of the individual and its ability to respond to the insult. Injuries extending deep into the vertebral column may lead to delayed death and associated welfare issues. The prognosis of this case was likely poor given the severity and location of the injuries, but the attempted rehabilitation and postmortem investigation provided valuable insights for clinical management if similar cases are encountered in the future. Being able to non-invasively assess and document traumatic injuries and other pathologies, diagnostic imaging is particularly useful in the clinical assessment and postmortem investigation (virtopsy) of cases with vessel-induced injuries.