Scapholunate dissociation is an injury caused by forced hyperextension of the wrist and results in characteristic radiographic features that may not be apparent on routine x-ray studies. In addition, significant ligamentous damage may be present even with normal radiographs. If misdiagnosed and improperly treated, this injury can lead to chronic wrist pain, instability, and degenerative changes. We present an illustrative case, review the pertinent literature, and present an algorithm for the evaluation and management of scapholunate dissociation.