The current concepts of anatomic and stable fixation followed by early mobilization in Monteggia fractures have clearly resulted in improvements in treatment and outcome. Bilateral Monteggia fractures are unusual and to the best of our knowledge have not been the subject of any reports in the literature. In this case report, we describe the operative technique for treating bilateral Monteggia fractures and the common pitfalls associated with this treatment. Despite the surgical and rehabilitative challenges posed by our patient's case, excellent results were obtained for both elbows.