<p>Endoprosthetic treatment of the wrist has made considerable progress over the last two decades. Whereas it used to be reserved almost exclusively for patients with rheumatoid arthritis, it is now also an established treatment option for posttraumatic osteoarthritis. Modern generations of implants offer significantly improved stability, lower loosening rates, and better osseous integration. The indication for wrist replacement often arises from the same clinical situation as for panarthrodesis: severe pain, functional limitations, and radiologically advanced signs of osteoarthritis. However, selecting the right patients is crucial for long-term success. Absolute contraindications (e.g., poor bone quality or high physical stress requirements) must be strictly observed. In rheumatoid arthritis, prostheses remain a&#xa0;valuable option, but the number of posttraumatic indications is increasing. Numerous studies have now proven the medium-term safety and effectiveness of modern implants. Survival rates after 8–10&#xa0;years are between 86 and 92%. Complications such as aseptic loosening, infection or dislocation are rare, but may require conversion to arthrodesis. Compared to total wrist arthrodesis, prostheses offer comparable pain reduction in patients with moderate functional requirements, but with the advantage of preserved mobility. The article highlights the indications, implant-specific aspects, clinical results, complications and special features of pre-operated wrists. The differentiated selection of suitable patients, preoperative planning, and careful implantation technique are crucial for the clinical outcome. Thanks to modern developments, wrist endoprosthetics are now playing an increasingly important role in the treatment of complex degenerative and posttraumatic diseases of the wrist.</p>