Brachial plexus injuries are common following trauma and surgical management of these injuries is critical for improving function and quality of life. Currently, the crux of surgically managing brachial plexus injuries lies in nerve transfers—which involves transferring a donor “expendable” nerve to a recipient outside the proximal zone of injury and ideally near the target muscle. In this chapter, the basic principles and techniques underlying nerve transfers are discussed. Furthermore, a brief review of the history of nerve transfers is summarized to give insight into the remarkable work of the pioneers in the field of peripheral nerve surgery and understand the evolution of our current techniques.