Heterotopic ossification frequently follows traumatic joint injuries, especially in individuals who have sustained central nervous system trauma. The elbow is particularly susceptible to ectopic bone formation. Fractures of the humerus, elbow, and forearm have all been shown to contribute to heterotopic bone formation about the elbow. Injury to the elbow may prove most disabling for the patient and most challenging for the physician. Joint ankylosis is a dreaded consequence and management remains unpredictable. We report a case of a patient with a completely ankylosed elbow secondary to heterotopic bone formation. The patient was injured in a motorcycle accident in which he sustained multiple fractures to his dominant arm as well as severe head trauma. The patient suffered from grade IV heterotopic ossificataion in his elbow with complete loss of motion and function for 4 years following his accident before surgical excision was performed. Successful surgical excision and treatment allowed the patient to achieve acceptable forearm arc of rotation and functional range of motion in his elbow. The patient was able to resume all activities of daily living and reported no recurrence of ectopic bone formation in the effected elbow.