Arthritis of the elbow resulting from either prior trauma or primary osteoarthritis is similar in that the end result is often a combination of pain and stiffness, but the location of the disorder can be different. Treatment decisions must be made on a case-by-case basis taking into account patient age, level of demand, and location and degree of degenerative changes. This article focuses primarily on the unique pathogenesis and general treatment rationale for primary osteoarthritis and posttraumatic arthritis of the elbow.