Wrist trauma often occurs in car accidents, falling from a height with the hand propped up on the ground, inadvertent falls and using the wrist to prop up the ground, and falls while performing sports activities. These injuries not only cause fractures and dislocation of the wrist bone, but also rupture of the ligaments in the wrist. Traditional surgery to treat joint injuries requires a large surgical incision to destroy the soft tissues around the joint and open the joint capsule before the joint can be observed and treated, which invariably results in another trauma to the joint. The disadvantages of traditional surgery are large wounds, post-operative pain and swelling, and long hospitalization days, plus large post-operative skin scars that significantly affect aesthetics. The use of wrist arthroscopy, which used to be primarily a diagnostic tool, has evolved in recent years to become a valuable tool in the treatment of various wrist disorders. With the use of wrist arthroscopy, the damaged area can be examined through a tiny entrance, the intra-articular cavity lesion can be properly evaluated and treated, and the repair of damaged structures within the joint can be performed through a small, minimally invasive opening to reduce unnecessary tissue destruction in order to shorten the duration of pain. The wound caused by the procedure is small and aesthetically pleasing, with minimal adhesions to the joint capsule and ligaments, short postoperative immobilization time, and early return to functional exercise. The standard arthroscopic approach to the wrist is mainly located on the dorsal side of the wrist. This is related to the relatively few vascular and neurological structures on the dorsal side of the wrist and the previous emphasis on evaluating the palmar ligaments of the wrist. The different dorsal approaches are named after their relationship to the extensor tendon sheath canal. The patient is operated in the supine position with the upper extremity abducted and under tourniquet control. An arthroscope with camera at a 30-degree angle is used, and traction is suspended. A standard wrist arthroscopy should include the articular surface of the distal radius, the proximal navicular and lunar bones, the lateral carpal palmar ligament, the navicular lunar interosseous ligament, the lunotriquetral interosseous ligament, and the triangular fibrocartilage complex. The approach used by the authors was to first establish a dorsal approach and then begin examining the navicular lunar interosseous ligament palmarly and the dorsal radial carpal ligament from the palmar radial approach to minimize the illusion of medically induced trauma to the dorsal articular capsule structures. If the patient has ulnar carpal pain, the palmar-ulnar approach is used to examine the palmar and dorsal ulnar radial ligaments of the lunar triangular interosseous ligament, the inferior ulnar extensor carpi radialis tendon sheath, and the radial attachment of the TFCC. The arthroscopy is then performed through the 3-4 approach, followed by the 4-5 and 6R approaches. The 6U approach is primarily used as an outlet, but can also be used for debridement in the case of lunotriquetral interosseous ligament tears. Arthroscopy of the midcarpal joint is performed to assess the integrity of the intertrochanteric ligament and to look for cartilage lesions or free bodies. Special arthroscopic approaches, such as the dorsal and palmar distal ulnar radial approaches and the 1-2 approach, may be used if needed. Examples of commonly performed arthroscopic procedures for the wrist and fingers (1) Staging and debridement and treatment of ischemic necrosis of the carpal/lunar bones (2) Excision of carpal cysts: palmar and dorsal: Osterman and Raphael l first performed arthroscopic excision of dorsal carpal cysts, with only 1 recurrence in 150 procedures (3) Evaluation/treatment of wrist instability: navicular lunar, lunar triangle, and midcarpal joints (4) (4) Triangular fibrocartilage complex (TFCC) injury: repair or debridement: TFCC injury can occur during a fall with the hand on the ground, when the wrist is subjected to axial stress in the extended, rotated anterior position. Other mechanisms of injury include injury from greater rotational or distraction violence. lindau and colleagues found that 39 of 51 patients with displaced distal radius fractures had combined TFCC tears and that distal ulnar radial instability was common at 1-year post-injury follow-up. palmer [77] classified traumatic TFCC injuries into four types. type IA injuries are central portion of the articular disc Type IB is a peripheral tear of the TFCC that may be combined with distal ulnar radial instability. type IC is a partial tear of the palmar ulnar carpal extrinsic ligament of the TFCC that may result in a posterior rotational deformity of the carpal bone relative to the ulna. type ID is an avulsion of the TFCC from its radial sigmoid notch attachment and is commonly seen in patients with distal radius fractures. Arthroscopically repairable peripheral-type tears of the TFCC include both IB and IC-type injuries. For symptomatic radial TFCC tears, they can be treated with debridement alone if the distal ulnar radial joint is stable, whereas repair is required if combined with distal ulnar radial joint instability. (5) Arthroscopic-assisted minimally invasive reduction and internal fixation of distal radius fractures: joint surface displacement or laceration of more than 2 mm is a typical indication for surgical treatment. Isolated radial styloid fractures and simple three-part fractures are best suited for this technique. Displaced intra-articular fractures of the distal radius are often combined with undetected intra-articular soft tissue injuries. Therefore, patients with suspected acute navicular lunar or lunotriquetral ligament tears or suspected TFCC tears resulting in distal ulnar radial instability are also indicated for surgery. (6) Arthroscopic-assisted minimally invasive internal fixation of navicular fractures: Arthroscopy can guide the determination of the entry point when placing screws from the proximal pole of the dorsal carpal navicular. Furthermore, arthroscopy is valuable in assessing fracture repositioning, avoiding screw penetration of the bone, and assessing fracture stability, as screws that appear to obtain a better grip do not necessarily provide adequate fixation of the comminuted fracture fragment.