BACKGROUND Extrusion of the talus is a very rare sequela of high energy trauma. There is limited information on these cases, given the rarity, with no consensus on treatment. Our case report demonstrates the radiographic and computed tomography (CT) findings in this injury. CASE REPORT We report the case of a 38-year-old female patient who was involved in a high energy trauma secondary to a motor vehicle accident. Lower extremity CT revealed talar extrusion with posteriorly displaced residual small fracture fragments and large pockets of emphysema in its expected location. Orthopedic management consisted of open reduction, debridement, and external fixation of the ankle, with an internal fixation placed afterwards. CONCLUSIONS Talar extrusion is a very rare entity with few cases reported in the literature. Prompt identification of extrusion of the talus is key given that treatment is time sensitive and surgical management is needed.