Radial styloidectomy (RS) is a surgical procedure used to address radioscaphoid arthritis and radioscaphoid impingement. It involves removing the distal portion of the radial styloid to relieve pressure on the radioscaphoid joint. The procedure can be performed open or arthroscopically. Open RS provides direct access but can be more invasive, while arthroscopic RS offers better visualization and preservation of volar radiocarpal ligaments such as the radioscaphocapitate (RSC). The key challenge in RS is preserving the integrity of surrounding structures, particularly the RSC ligament, to avoid complications such as instability and ulnar carpal translation.