Elbow arthroscopy is being used with increasing frequency to treat a number of pathologies. The lateral aspect of the elbow is often a source of pathology and a variety of portals exist to treat conditions in this area. We describe an accessory portal to add to the surgeon's armamentarium for the diagnosis and management of lateral elbow pathology. The main indications for this portal are diagnostic arthroscopy, synovectomy, removal of osteophytes or loose bodies, radial head excision, and debridement/microfracture of the radiocapitellar joint surfaces. It is safe and allows direct visualization and access to the posterolateral radiocapitellar joint, the olecranon articular surface, and the reciprocal humeral trochlear. In the more lax individual or in the younger patient, we have also been able to visualize across to the front of the radiocapitellar joint.