Pigmented villonodular synovitis (PVNS) is a disease rarely found in the elbow. In the setting of previous trauma, there are no documented reports of PVNS occurring in the posttraumatic state. We report a case of elbow PVNS in a 16-year-old male with a history of traumatic injury to the supracondylar humerus and olecranon, resulting in nondisplaced fractures, diagnosed 3 years prior to presentation. We diagnosed posttraumatic PVNS of the elbow using a combination of plain radiographs, ultrasonography, and MRI, along with an infectious, hematologic, and rheumatologic workup. This workup cumulates in open elbow débridement of synovial tumor, with pathology confirming our preoperative diagnosis of PVNS. A literature search and review of PVNS in the elbow yield only 54 results, none of which is related to previous fracture. In the neurosurgery literature, however, there is a case report of a pathological fracture of the odontoid related to PVNS.