This comprehensive review discusses wrist arthritis in young patients while discussing the evolution of wrist arthroplasty and its use in this population. Here, we emphasize the challenges of managing arthritis in a high-demand, younger population and review historical to modern implant designs, including their benefits, complications, and outcomes. Ultimately, while modern implants show improved outcomes, long-term success in younger patients remains uncertain, necessitating cautious patient selection and personalized treatment plans.