The objective of this review is to contribute information that improves surgical outcomes and to provide management guidelines for various lesions of the brachial plexus. This review was based on the analysis of 1,019 cases of brachial plexus injuries, entrapment, and tumors that were surgically treated at Louisiana State University Medical Center between 1968 and 1998. We describe surgical outcomes of 859 cases, excluding 160 thoracic outlet syndrome cases. Mechanisms of injury included 509 stretch injuries, 118 gunshot wounds (GSWs), 71 lacerations, and 161 neural sheath tumors. Functional outcomes after surgical repair are encouraging. A functional recovery of grade 3 or better was seen in 87% of the stretch injury cases having lesions in continuity, 71% of those repaired with sutures, and 53% of those that underwent graft repairs. In the GSW group, 129 of 202 of the injured plexus elements that had suffered complete loss recovered to grade 3 or better levels. In comparison, 85 of the 91 lesions with incomplete loss of function eventually recovered. Of the lacerating injuries that were repaired, more than 65% of the elements recovered to a grade 3 or better level. Of the 161 neural sheath tumors arising from brachial plexus, most schwannomas and solitary neurofibromas were resected without significant deficits. These surgical results suggest that surgical exploration and repair of brachial plexus lesions are technically feasible and may obtain favorable outcomes if patients are selected appropriately. This review provides management guidelines that may enhance functional outcomes of brachial plexus surgery.