The brachial plexus consists of nerve roots C5-T1. Upper brachial plexus roots (C5-C6) innervate proximal muscles of the shoulder and upper arm. Injuries causing root avulsion or rupture require intensive treatment and significantly impact patients' quality of life. Nerves regenerate extremely slowly and without treatment, patients with upper brachial plexus lesions may lose motor function distal to the injury. Upper brachial plexus reconstruction using nerve transfers is a new method to bypass damaged areas thereby allowing patients to regain critical arm functions faster. We present a review of brachial plexus cadaveric anatomy, reconstruction transfer techniques, and management.