Inadvertent neodymium: yttrium-aluminum-garnet (Nd:YAG) capsulotomies are rare, with only one incident reported in the literature prior to the present case. We discuss the management of a phakic patient with a dense posterior subcapsular cataract who underwent yttrium-aluminum-garnet (YAG) capsulotomy for presumed posterior capsular opacification. Operative course involved cataract surgery with anterior vitrectomy for prolapsed lens fragments due to the disrupted posterior capsule. This patient experienced excellent visual outcomes postoperatively, with ultimate best-corrected visual acuity of 20/20. This case underscores the importance of thorough preoperative time out, including confirmation of patient's understanding of the intended procedure.