The serratus anterior muscle provides proximal stability to the shoulder complex to enable end-range shoulder flexion and abduction. Axonal injury to the long thoracic nerve leads to loss of scapular protraction and upward rotation of the scapula with subsequent loss of overhead function. The thoracodorsal-to-long thoracic nerve transfer has been shown to be a reliable surgical option that provides some recovery of scapular stability. Motor reeducation following this transfer is complex due to the lack of synergy between donor and recipient muscles. Rehabilitation begins within the first month postoperatively and focuses on donor activation with latissimus dorsi exercises. Patient education, donor activation, and combined donor-recipient movements are included in phase 1. Exercises are advanced based on manual muscle testing (MMT) scores of the serratus muscle. Phase 2 is initiated once palpable serratus contraction is noted and involves progression of exercise to active-assisted protraction and shoulder flexion with donor co-contraction. Individuals who recover full motion against gravity without scapular winging advance to phase 3 with the gradual introduction of resistance training.