Restoration of motor or sensory function following peripheral nerve injury can be achieved with nerve transfers. Expendable nerves are redirected to an injured nerve to recover motor or sensory function. In the past 50 years, advancements in microsurgery, including the sterile intraoperative microscope and electrodiagnostic studies, have led to the evolution of nerve transfers as a reliable reconstructive option for individuals with loss of peripheral nerve function. Traditionally, much of this surgical exploration involved complete brachial plexus injuries. Recent advancements include reverse end-to-side transfers leaving the potential for native nerve recovery and lower extremity nerve transfers.