The pathology of elbow stiffness can be categorized into both intra-articular and extra-articular derangements, which commonly occur in combination. The etiology of the stiff elbow, likewise, can be classified into nonarthritic causes, such as surgery, trauma and certain systemic conditions, and arthritic causes, such as osteoarthritis and rheumatoid arthritis. Current arthroscopic techniques can be used to successfully manage both the arthrofibrotic and the arthritic elbow, when appropriately indicated. This article will review the indications, management principles and arthro-scopic techniques for treating the stiff elbow, highlighting anatomic considerations, and the differences in technical guidelines when treating arthrofibrosis versus arthritis.