The potential for pile tip damage and extrusion buckling has become an increasing concern for the offshore wind industry following the trend toward the use of large-diameter thin-walled pile foundations, either as monopiles or as part of a jacket structure. Extrusion buckling may be triggered by an initial pile tip fabrication imperfection or pile damage during transport and handling. It may also be triggered during driving through strong heterogeneous sediments. Numerical analysis of the problem requires advanced and computationally expensive techniques because of the three-dimensional, dynamic and large-deformation nature of the pile and soil deformations. The problem is addressed here by combining coupled Eulerian–Lagrangian simulations with geotechnical centrifuge model test data in dry dense sand. Both approaches consider pre-dented piles with the objective of estimating the soil strength, characterised by the cone resistance, at which minor initial damage will start to propagate. Simplified analysis of structural dent propagation and radial stresses generated in the soil during advance of a deformed pile led to a simple calculation procedure to assess the potential for extrusion buckling. Reasonably good agreement was achieved between the proposed calculation method, numerical simulations and centrifuge tests data, rendering the approach a valuable screening tool for practical application.