Neglected old dislocations of elbow are found only in developing countries in significant numbers and there is very less literature of this condition from developed countries. It is a huge challenge for orthopaedic surgeons in developing countries as even after treatment it is difficult to achieve full range of motion and function in a neglected case. In this article we report treatment and results of one of the largest series of 15 cases on neglected posterior elbow dislocation. Our management protocol was opening joint through posterior approach and using Speed Technique doing a V-Y plasty for tricep and most of times fixing reduced joint by 2 diverging k wires. At one year follow up