Proximal row carpectomy (PRC) has earned a respected place in the hand surgeon's armamentarium. Prerequisites for the standard PRC are good cartilage on the proximal pole of capitate and in the lunate fossa of radius. If there is cartilage damage on the proximal pole of capitate, the modification of Salomon and Eaton is a reasonable alternative to the standard PRC. The most important surgical step is preservation of the radioscaphocapitate ligament. Good long-term results can be achieved, and with careful patient selection the operation can be done successfully in people who use their hands for heavy work.