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Obturator hip dislocations are exceedingly rare, comprising <5% of hip dislocations1, with an even smaller percentage of these dislocations involving penetration of the obturator foramen with an irreducible intrapelvic femoral head. There are no reports of this in the pediatric population. We report a case of a 16 year old male who presented with a trans obturator hip dislocation which was irreducible by closed means and underwent open reduction. The open reduction was complicated by intraoperative acute physeal separation, also known as epiphysiolysis. This was managed with reduction of the epiphysis and fixation with a fully threaded screw, followed by reduction and capsular repair. The combination of this injury and subsequent complication has not been previously reported in the literature. Our report and focused review of the relevant literature should guide clinicians who encounter a similar clinical scenario.