Nerve transfers have increased in popularity over the last thirty years in the upper extremity but have only recently begun to be performed in the lower extremity. Applications have ranged from deficits due to trauma, malignancy, viral-mediated nerve palsies (acute flaccid myelitis), and iatrogenic injuries. If multiple nerves within the lower extremity are affected, priority is given to re-innervating proximal muscle groups first and then proceeding distally (Moore et al., Plast Reconstr Surg Glob Open. 9:e3699, 2021). Experience in the literature is limited to small case series, and variable recovery of strength is reported. Our early experience with these transfers has made a significant difference in patients’ quality of life, functionality, and independence. This chapter provides the surgical techniques for commonly reported nerve transfers in the lower extremity.