Mechanical damage in subsea pipelines in the form of local dents / buckles due to excessive bending deformation may severely threaten their structural integrity. A dent / buckle has two significant effects on the pipeline integrity. Notably, residual stresses are set up as result of the plastic deformation and stress concentrations are created due to change in pipe geometry caused by the denting / buckling process. To assess the criticality of a dent / buckle, which often can be associated with strain induced flaws in the highly deformed metal, integrity assessment is required. The objective of this paper is to evaluate the severity of dent / buckle in a 48” subsea pipeline and to make the rerate, repair or replacement decision. This paper presents a Level 3 integrity assessment of a subsea pipeline dent / buckle with metal loss, reported in in-line inspection (ILI), in accordance with Fitness-For-Service Standard API 579-1/ASME FFS-1. In this paper, the deformation process that caused the damage (i.e. dent / buckle) with metal loss is numerically simulated using ILI data in order to determine the magnitude of permanent plastic strain developed and to evaluate the protection against potential failure modes. For numerical simulation, elastic-plastic finite element analyses (FEA) are performed considering the material as well as geometric non-linearity using general purpose finite element software ABAQUS/CAE 2017. Based on the numerical simulation results, the integrity assessment of dented / buckled subsea pipeline segment with metal loss has been performed to assess the fitness-for-service at the operating loads.