A case involving late injuries to pelvic vessels caused by a sliding hip screw penetrating through the acetabulum has not been previously reported. We present the case of an 88-year-old man who presented with a retroperitoneal and extraperitoneal hematoma 4 months after open reduction and internal fixation of an intertrochanteric hip fracture. Surgical exploration showed a laceration of the left external iliac artery, which was repaired. However, the sliding hip screw was left in place. The patient's condition deteriorated, and he expired 2 days later. Postmortem examination revealed a laceration of the left internal iliac vein. Our calculations show that the compression screw utilized in the fixation may not have been properly engaged into the sliding screw.