The axillary-to-triceps nerve transfer helps to restore triceps function both in patients with lower plexus injuries (C7 and below) and in those with mid-level cervical spinal cord injuries. Triceps function is important for many daily activities where extension power is required, such as reaching, stabilization of an object on a table, wheelchair propulsion, pressure relief, and transfers. The posterior branch of the axillary nerve is typically used as the donor nerve, so a combination of shoulder abduction, extension, and external rotation may be emphasized during motor retraining. Postoperative therapy includes three phases based on the donor activation focused rehabilitation approach. Therapy progresses based on results of monthly manual muscle testing of the recipient triceps muscle. Frequent donor activation with active posterior shoulder abduction (extension with or without external rotation) is encouraged throughout the first two phases. Exercises and functional activities that combine donor motion with assisted and ultimately active elbow extension are included in the motor reeducation program. Functional strength of the triceps may not be observed until 12–14 months after surgery.