Trapeziometacarpal arthrosis is an expected part of normal human aging.» The radiographic severity of trapeziometacarpal arthrosis may not correlate with symptom intensity or magnitude of limitations.» Psychosocial factors may be important drivers of symptom intensity, magnitude of limitations, and seeking of treatment.» Nonoperative treatment is palliative and not disease-modifying, but may facilitate long-term adaptation.» Current surgical treatment strategies center around trapeziectomy, but it is unclear whether the addition of other stabilization or interposition techniques changes overall outcomes. Epidemiology Disclosure: There was no source of external funding for this study. The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/ JBJSREV/A411).