The definition of a functional elbow is changing alongside the evolution of technology and its implications in our daily activities. Elbow function and range of motion can be compromised by several causes, resulting in many different types of elbow stiffness. The proper diagnosis and adequate treatment of this entity remain a challenge for the modern orthopedic surgeon. Conservative treatment is an effective option, but when it fails surgical treatment should be considered. Several factors should be taken into account when operating on a stiff elbow, including those related to the elbow, and those related to the patient and its social and psychological contexts. Elbow arthroscopy has evolved substantially in the past decades and the arthroscopic treatment of elbow stiffness is nowadays the preferred option in selected cases, with encouraging published results. This chapter focuses on the arthroscopic treatment of the stiff elbow.