Coronal malalignment due to malrotated trochanteric nail placement in femoral fracture fixation has never been reported. We present a case of a femoral segmental fracture fixed with a trochanteric nail, with a malrotated placement resulting in a valgus malaligned nail and femur, associated with a rotational malalignment. Knowledge of the modern nail design with proper intra-operative precautions, would avoid this underestimated technical error.