Background Galeazzi fractures are fractures of the distal radial shaft with disruption of the distal radioulnar joint (DRUJ). These injuries are relatively rare, constituting <3% of pediatric forearm fractures and <7% of adult forearm fractures. The fracture pattern is inherently unstable and most often requires surgical treatment to prevent loss of reduction. Surgical repair of the Galeazzi fracture may also include fixation of the ulnar styloid, triangular fibrocartilage complex (TFCC) repair, and possible fixation of the ulnar to the radius. Outcomes after surgical treatment have been demonstrated to be highly favorable, with the majority of patients experiencing positive return to function. Purpose This video overview and case presentation demonstrates the diagnostic and surgical approach to the treatment of the Galeazzi fracture. Methods The anatomy of, mechanism of, diagnosis of, and treatment options for the Galeazzi fracture are reviewed. We discuss surgical indications and considerations, including fracture sequelae and operative approach. A case of a 36-year-old woman with a Galeazzi fracture is presented, including the diagnosis, surgical technique, and postoperative plan for rehabilitation. Results Fracture fixation was achieved intraoperatively. Postoperatively, the patient demonstrated good motion and restoration of the forearm and wrist. Conclusion Galeazzi fractures are inherently unstable injuries that require surgical fixation for optimal results. A thorough understanding of the anatomy, surgical approach, and postoperative treatment course is essential for a favorable patient outcome.