Recovery of active prehension is the priority when reconstructing hand function. Restoring innervation to the anterior interosseous nerve (AIN) best achieves this function when nerve transfers are considered in the reconstructive plan. Several nerve sources can successfully target this nerve, but in lower plexus injuries and spinal cord injuries, our preferred sources have been the branches of the musculocutaneous, radial, and median nerve that are innervated by higher levels of the spinal cord and in contexts in which these would avoid a donor deficit. The essential anatomy, surgical approach, and donor selection criteria are discussed. It is critical to increase awareness of these procedures among the medical and patient community to ensure optimal and timely care is provided to this population. Nerve transfers are a powerful tool that should be considered in all plans for functional restoration of the hand following brachial plexus or spinal cord injury.