Case Overview This video demonstrates an intercostal nerve transfer technique with the use of a sural nerve graft for the management a traumatic brachial plexus injury. Indications, contraindications, technical pearls, and potential pitfalls are discussed. Preoperative and postoperative imaging studies and are included. Method/Technique The video demonstrates a step-by-step technique for intercostal nerve transfer for the management of brachial plexopathy, with a focus on increasing operating room efficiency. Results Historical results and outcomes of intercostal nerve transfer for the management of brachial plexus injuries are reviewed, and the outcome of the patient in our case presentation is discussed. Summary This video demonstrates intercostal nerve transfer with the use of a sural nerve graft for the management of a traumatic brachial plexus injury. Indications, contraindications, technical pearls, and potential pitfalls are discussed.