Open scapulothoracic dissociation (SD) is a rare injury and an average orthopaedic surgeon might be practically unaware of this entity. To our knowledge, there are hardly any cases of open SD reported in the English literature. We present one such case of open injury associated with total brachial plexus injury, but without any component of vascular injury. The patient was managed by aggressive debridement and fixation of the osseous injury which helped us save the patient from the dreadful complication of sepsis associated with such a severe injury. We briefly review the literature regarding SD and also discuss the management options when encountered with such a severe and rare injury.