A case report of acute traumatic orbital encephalocele related to orbital roof fracture and its management were presented. Acute traumatic encephalocele related to orbital roof fracture is unusual. Early diagnosis and treatment are very important since the raised intraorbital pressure may irreversibly damage the optic nerve. Orbital computerized tomography with thin axial and coronal sections should be performed in an acute traumatized patient with a concurrent orbital trauma. Reconstruction of the orbital roof is the key step of the surgical treatment and should be performed in every case. Porous polyethylene (Medpor (R)) has been used for many years in reconstructive surgeries and it is superior to other allografts in many ways. In our case, the orbital roof reconstruction was done by Medpor (R) and the early and late cosmetic results were excellent. The important features of acute traumatic encephalocele secondary to orbital roof fractures in terms of presentation, diagnosis and surgical steps were also stressed.