INTRODUCTION AND IMPORTANCE: Orbitocranial penetrating injuries (OPI) are uncommon types of head injuries, accounting for about 0.04% of all head injuries. Foreign bodies penetrating the orbit and cranium cause fractures, leading to ophthalmic and neurological manifestations. These require a specialized treatment approach that mainly depends on the foreign body type, extent of injury, and potential complications. Management involves foreign body removal, reconstruction, and infection control. CASE DETAILS: We discuss a case of a 25-year-old male who presented with a penetrating cranio-orbital injury caused by a wooden stick through the left eye. The transorbital-transcranial wooden foreign body penetrated the orbital roof and temporal bone causing displacement of the orbital contents and extended intracranially into the temporal region. The management was done by a multidisciplinary approach consisting of a team of neurosurgeons and oculoplastic surgeons by extracting the foreign body and reconstruction. CLINICAL DISCUSSION: No sound literature on the management of OPI by neuroplastic surgery is available. CONCLUSION: This article highlights the importance of neuroplastic surgery for reconstructing complex fractures involving the cranio-orbital and craniofacial regions for improving patient outcomes, and preventing potential complications. This could potentially revolutionize the management of complex craniofacial abnormalities and a new era for neuro-reconstructive care.