Wrist stiffness secondary to degenerative arthropathies or rheumatoid arthritis has a broad range of surgical treatment options. These procedures have been well described in the literature to understand advantages, risk profiles, and common pitfalls, as well as to determine how variation in surgical techniques or approach can alter the outcome of surgery. Preoperative radiographs remain a fundamental aspect of the imaging workup prior to any surgical intervention, and advanced imaging modalities with computed tomography and magnetic resonance imaging allow for further evaluation of the carpal bones, joint articulations, and ligamentous stabilizers. Surgeons should be aware of these soft tissue and bony considerations during the preoperative planning stage in order to optimize outcomes and achieve the goals of surgery.