Osteoarthritis of the wrist is a complex pathology that can involve a wide range of clinical situations and a variety of etiologies. Because of the many variations in the cartilage surfaces affected, it is important to be aware of the different treatments available, depending on the location of the disease. When osteoarthritis first appears, surgery is generally palliative and non-conservative. Since open surgery often results in significant stiffening, arthroscopy is now being used to reduce invasiveness. Other solutions are also possible under arthroscopy. In this chapter, we present the current surgical possibilities of arthroscopic management of osteoarthritis of the wrist, as well as our tips for performing this demanding surgery.