Heterotopic ossification (HO) is the formation of mature lamellar bone in extra-osseous tissues, mostly commonly in the hip and elbow joint. The development of HO at the elbow can cause limitations to the elbow’s range of motion significantly affecting quality of life. The lack of full understanding of the etiology of the formation of HO limits preventative measures and treatment. This chapter’s aim is to present a reliable early arthroscopic technique for excision of HO about the elbow. Indications for this procedure are evidence of heterotopic bone about the elbow with a progressive loss of range of motion. Important physical exam findings include: decreasing range of motion at the elbow, localized swelling, and bogginess noted when palpating the capsule. Imaging can help with surgical planning and may consist of plain radiographs and/or magnetic resonance imaging. While positioning is predicated on surgeon preference, prone positioning has been utilized with great success. Portal placement may vary however it is most important that the surgeon be aware of all neurovascular structures that may be at risk. Furthermore the excision of the HO is best performed in a methodical set pattern and it is crucial to evaluate the excision under fluoroscopy before completing the procedure. Post-operatively patients receive radiation therapy, physical therapy, and postoperative medications including: Doxycycline, Prednisone, and Indomethacin. Potential complications to be aware of are neurovascular injury, drainage from portal sites, and HO recurrence. With a full understanding of the extent of the HO on pre-operative imaging/evaluation, awareness of neurovascular structures at risk, and use of a systematic technique for excision early arthroscopic management of HO of the elbow has shown satisfactory results.