Pisotriquetral pathology is an important reason for ulnar-sided wrist pain and is frequently overlooked. Cadaveric studies illustrate a high prevalence in the older population. Physical examination is important in diagnosing PT pathology. X-rays and CT-scans can assist in diagnosing PT pathology. Splinting and steroid injections are the treatment of first choice in the absence of PT arthrosis. In case of persistent pain or arthrosis, pisiformectomy should be performed. Pisiformectomy does not cause loss in range of motion, grip strength or carpal instability