Wrist denervation is a valuable technique for managing chronic wrist pain while preserving motion and future surgical options. Initially described by Wilhelm (2001), the procedure has evolved to minimize incisions and complications. This paper reviews key considerations, including the role of preoperative diagnostic blocks, anatomic understanding of wrist innervation, procedural variations, and potential complications. It examines the evidence for isolated posterior interosseous nerve (PIN) neurectomy, combined anterior interosseous nerve/PIN neurectomy, and total wrist denervation, highlighting limitations due to poor reporting and lack of controlled studies. Future directions include refining denervation techniques through improved anatomic understanding and standardized outcome data collection.