This video shows carpometacarpal arthroplasty using abductor pollicis longus suspension. Indications, contraindications, technical pearls, and potential pitfalls are discussed. Preoperative and postoperative imaging studies are presented. A slip of the abductor pollicis longus is weaved around the appropriate tendinous structures of the forearm to produce the sling. Historical results and outcomes from the literature are presented and discussed.