Both soft tissue and bony instability can cause the elbow to be unstable and this instability can be acute or chronic. Nonoperative treatment including early motion and muscle activation is indicated in most patients. Depending on the type and severity of the instability and patient factors, surgery may be indicated by either open or arthroscopic techniques or a combination of both. There are several advantages of an arthroscopic approach to elbow instability. First, it is a minimal invasive technique, allowing for an evaluation and possibly treatment of the entire joint, decreasing morbidity of the elbow’s soft tissues. It is, however, technically demanding and may, therefore, be less suitable for less experienced surgeons. The arthroscopic evaluation and treatment of elbow instability will be discussed in this chapter.