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Abstract Background Trauma-induced orbital blowout fracture (OBF) with eyeball displacement into the maxillary sinus is rare. Case presentation We present the case of a 14-year-old with a closed head injury, OBF, and displacement of the eyeball into the maxillary sinus following a car accident. A prompt transconjunctival access surgery was performed for eyeball repositioning and orbital reconstruction in a single session, mitigating anaesthesia-related risks associated with multiple surgeries. At the 12-month follow-up, his visual acuity was 20/200. Despite limited eye movement and optic nerve atrophy, overall satisfaction with the ocular appearance was achieved. Conclusions This report offers novel insights into the mechanisms of OBF occurrence and the development of postoperative complications.