This paper reports a case of total elbow arthroplasty for mutilans deformity with olecranon fracture in rheumatoid arthritis. A 55-year-old woman presented with a 12-year history of arthritis involving the hands, wrists, hips, knees, ankles, and elbows. She had already undergone bilateral TKA and THA. She could walk only with a pair of crutches. At one point she stumbled and fell, fracturing her left olecranon process. She underwent total elbow arthroplasty and osteosynthesis. The fracture was treated with tension-band wiring after the components were implanted. Three weeks later, pain was completely relieved and she was able to walk with crutches. The arc of flexion ranged from 20 degrees to 120 degrees. The result of the operation was satisfactory. During the operation, we suffered approach, prosthetic selection and humeral component placement.