The occurrence of complete decapitation as a consequence of car accident is an extremely rare event. This fatality is generally seen in pedestrians run over by trains and also in motorcyclists who impact against the tailboard of trucks. Moreover, complete transection of pedestrians and occupants of cars has been described in road accidents especially in case of vehicles traveling at a high speed. We present a case of decapitation with complete degloving injury of the neck in a patient involved in a traffic accident, and we briefly discuss the possible mechanisms producing this injury.