Total elbow arthroplasty (TEA) is commonly employed for cases of humeral bone loss. Success of the procedure depends on both the surgical technique and implant design. Current surgical techniques in TEA generally employ visual cues for estimating the flexion-extension (FE) axis. However, it has been shown that this approach can result in alignment errors upwards of 10° . Computer-assisted orthopaedic surgery (CAOS) employed at the hip and knee has led to an improvement in the accuracy and reproducibility of the procedure, with implant alignment errors approaching 2–3 degrees . TEA may well benefit from the accuracy of CAOS.