Osteochondritis dissecans (OCD) is an inflammatory process affecting the articular surface of the capitellum of the distal humerus. Preoperative evaluation consists of monitoring function, range of motion, and pain and obtaining a thorough history of the onset of symptoms. Plain radiographs are usually sufficient to delineate the lesion, but magnetic resonance imaging (MRI) can occasionally be helpful to further outline the nature and exact location of the pathology. With progression of symptoms and deterioration of function, surgery is indicated, because the natural history is one of continued elbow dysfunction and can ultimately result in permanent joint deformity. This chapter outlines surgical approach, with an emphasis on arthroscopy, technique, and results. Specific complications are also mentioned.