Radial nerve injuries are functionally debilitating and necessitate the restoration of wrist, finger, and thumb extension. Tendon transfers have historically been the reconstructive strategy of choice; however, nerve transfers have emerged as an exciting alternative option. Expendable median nerve donors are utilized to reconstruct wrist and finger extension. Nerve transfers that take advantage of the synergistic tenodesis actions of wrist extension with finger flexion and wrist flexion with finger extension are typically preferred to facilitate the ease of relearning. These nerve transfers are often combined with a pronator teres to extensor carpi radialis brevis tendon transfer to act as an early internal brace to maintain wrist extension while waiting for reinnervation. This chapter outlines the clinical indications, relevant anatomy, detailed surgical technique, and expected outcomes of nerve transfers for radial nerve palsy.