The triangular fibrocartilage complex (TFCC) is an intricate structure that plays an important role in providing distal radioulnar joint stability and load transmission at the ulnar wrist. Understanding this structure is critical for creating treatment plans based on patient history, physical examination, and imaging. Arthroscopic, arthroscopic-assisted, and open surgical treatment options exist for tears meeting distinct surgical criteria that are discussed in this article. Although long-term comparative outcomes studies are limited, long-term retrospective outcome studies of TFCC repair and reconstructive techniques demonstrate improvement in pain, stability, range of motion, and disability.