The most frequent cause of high-flow priapism is penile or perineal closed trauma with laceration of the cavernous artery and the formation of an arterial - lacunar fistula. We present the case of a high-flow priapism due to closed perineal trauma and damage to the left cavernous artery which completely resolved following conservative treatment. The case was documented by duplex Doppler ultrasound and selective pudendal arteriogram before and after resolution.