We report a case of a 44-year-old male with an uncommon case of an open dorsal proximal interphalangeal (PIP) dislocation. Although open PIP dislocations are often volar, dorsal dislocations are fraught with complications due to the potential for infection and damage to supportive structures. Features of this case are discussed together with its implications, including lack of standardized management in the literature, use of a closed reduction following copious irrigation, and requirement for antibiotic use.