Peripheral nerve injuries (PNI) are a complex heterogeneous group of disorders and require a thorough understanding of management strategies to help optimize recovery. The basic prerequisite is to be able to create optimal conditions for axonal regrowth. A multidisciplinary involvement, including neurosurgeons, plastic surgeons, hand surgeons, orthopedicians and, more importantly, physiotherapists is mandatory. This chapter addresses the anatomy of a peripheral nerve, the classification of nerve injuries and the acute management in general. Individual nerve injuries are not discussed.