The treatment of the uncommon symptomatic and neglected Monteggia fracture-dislocation of childhood can pose a significant clinical problem because of pain, decreased range of motion, unstable cubitus valgus, and possible nerve damage. This unusual injury is presented with a detailed description of a modified Bell Tawse annular ligament reconstruction. The modifications of the procedure simplify it and more closely duplicate the anatomy of the annular ligament. This procedure is indicated in the treatment of the symptomatic and neglected Monteggia fracture-dislocation of childhood.