Pulled elbow is a common childhood injury, most frequently in under fives is usually caused by pulling on the child's arm or the forearm of a resisting child. It causes subluxation of the head of radius from its encirclement by annular ligament. There are circumstances in which the clinical history is unknown or atypical and reduction of the entrapped annular ligament is not successful. In such cases, MRI may be useful to make a definite diagnosis and confirm successful reduction. To our knowledge, there has been no reported case in which spontaneous reduction was confirmed by follow-up MRI after subsequent immobilization of the affected arm with the splint due to unsuccessful manual reduction of atypical pulled elbow. Here we report such a case and review literatures with regard to pulled elbow.