Intra-articular fractures of the distal humerus are among the most challenging fractures to manage. Nonoperative treatment, although appropriate for some patients, often leads to loss of motion and unsatisfactory functional outcomes. Over the last 2 decades, enhanced operative techniques and implant designs have improved the reduction and stability of distal humerus fractures leading to better outcomes. Careful preoperative planning, adequate exposure, and stable fixation facilitating early mobilization are essential to achieve successful outcomes with internal fixation.