The flexor digitorum superficialis (FDS) muscle is innervated by the median nerve and is a vital muscle for functional grasp. Axonal injury to the median nerve leading to loss of hand dexterity and grasp may be addressed with a nerve transfer of the radial nerve branch of the ECRB to the median nerve branch of the FDS. The synergistic nature of this transfer may contribute to its functional success. Postoperative rehabilitation is initiated within the first month and is guided by the three-phased donor activation focused rehabilitation approach (DAFRA). Patient education regarding pertinent anatomy and active donor (wrist extension) is emphasized in phase one. Active response in the recipient FDS is the hallmark for advancing to phase two, in which donor activation continues (wrist extension) combined with active-assisted finger flexion. Phase three advances to resisted exercises and functional activities, which involve hand strength.