Post-traumatic osteoarthritis of the elbow is an uncommon condition in which the clinical manifestations are often at variance with the radiological findings. In symptomatic forms, pain and stiffness are variably combined. When non-operative management fails, the decision to perform surgery is taken on a case-by-case basis depending on age, activity level, patient discomfort, and osteoarthritis location and severity as assessed by CT scan arthrography. Elbow instability or subluxation should be sought. Post-traumatic elbow osteoarthritis raises difficult therapeutic problems in young patients. The goal of treatment is to obtain a low level of pain with sufficient motion range to ensure good function, while preserving future surgical options and delaying elbow arthroplasty to the extent possible.