A 67-year-old unvaccinated male patient was analyzed. Clinical manifestations, laboratory and imaging findings, treatment, and disease progression were evaluated using hospital records. Eight days after facial trauma from a bicycle accident, the patient developed progressive trismus, dysphagia, neck stiffness, and respiratory discomfort. He was hospitalized on day 10 post-injury. Initial treatment included 500 IU of tetanus immunoglobulin. Two days later, his condition deteriorated with progression to generalized tetanus, requiring ICU admission. Additional 2000 IU of tetanus immunoglobulin, sedation, and oxygen therapy were administered. The course was complicated by pneumonia. Gradual improvement occurred, and he was discharged in stable condition on day 35. Cephalic tetanus is a rare but severe form that may progress to generalized disease. Early recognition and prompt administration of tetanus immunoglobulin are crucial for favorable outcomes.