The triceps muscle provides the sole source of elbow extension. This movement is vital to activities of daily living, such as reaching overhead to dress and bathe. Additionally, it provides elbow stabilization for transfers. Restoration of active elbow extension is achievable with the intercostal nerve to triceps branch of the radial nerve transfer. Rehabilitation is initiated following 2–4 weeks of postoperative rest and follows the three phases of the donor activation focused rehabilitation approach (DAFRA) to nerve transfer motor reeducation. Patient education and donor activation exercises are the hallmarks of phase 1. These include trunk flexion/rotation and inspiration/expiration. Pairing the active donor muscle with passive elbow extension is initiated during phase 1 as well. Monthly manual muscle testing (MMT) assessments of recipient function guide the advancement of the rehabilitation phases. Phase 2 begins once movement is noted with triceps activation. During this phase, donor activation exercises (trunk flexion/rotation and inspiration/exhalation) are paired with assisted elbow extension and begin in a gravity-assisted plane. Resisted elbow extension exercises are initiated in phases 3, once a 3/5 MMT is achieved. If adequate triceps strength is achieved, efforts are made to de-emphasize the donor for greater independent triceps function. There is often a protracted timeline for recovery following this nerve transfer potentially involving several years before the patient reaches this stage.