This video shows open reduction and internal fixation with distal radius bone graft for management of a scaphoid nonunion. Indications, contraindications, technical pearls, and potential pitfalls are discussed. A dorsal approach to the scaphoid and distal radius is used. Headless screws are used for fixation. Favorable outcomes have been reported in patients with scaphoid nonunion who undergo treatment with the use of vascularized bone graft from the distal radius. Published results of the procedure are discussed.