Nonunion of the scaphoid is a challenging complication of the scaphoid fracture. Unfavorable blood supply of the scaphoid causes an increased risk of nonunion, even with appropriate treatment interventions. Therefore, the search for new therapeutic options has begun to overcome the poor blood supply and improve the osteogenic capacity of the avascular nonunion site. As a result, vascularized techniques became popular, and several techniques have been proposed. Locally pedicled bone grafts and free vascularized bone flaps are the two main groups of treatment having unique superiorities over each other. This chapter summarizes the vascularized treatment modalities in treating scaphoid nonunions.