Wrist instability most commonly results from ligamentous disruption between bones of the proximal carpal row. Scapholunate and lunotriquetral dissociation are forms of this instability pattern. Carpal instability can also occur due to loss of the normal ligamentous restraints between the carpal rows. Ulnar midcarpal instability is an example of this pattern. The treatment of wrist instability depends on the specific type and degree of carpal disruption and the presence or absence of degenerative changes. Options include soft-tissue reconstruction, partial wrist fusion, limited carpal bone excision, or a combination of methods.