The purpose of this study is to report the prospective results of total wrist arthroplasty in a consecutive series of patients treated by a single surgeon. A consecutive series of twenty-seven wrist arthroplasties in twenty-three patients were followed prospectively for a mean of 7.4 years (range 5.0-10.9 years). Twenty patients had rheumatoid arthritis, one had primary osteoarthritis, one had scapholunate advanced collapse (SLAC), and one had arthritis secondary to Kienbocks disease. Outcome measures include the Disabilities of the Arm, Shoulder and Hand (DASH) score, wrist range of motion, and standard radiographs. Mean wrist flexion and extension at final follow-up for intact implants were 40 and 24 degrees respectively, for a mean improvement in the total flexion-extension arc of 13 degrees. Average DASH score improved from 58 points preoperatively to 35 points at five years after surgery. A total of nine wrists in eight patients had undergone revision surgery for a loose carpal component at the time of final follow-up; all revisions were in patients with diagnoses of rheumatoid arthritis. Two additional wrists in two patients had radiographic evidence of carpal component subsidence at final followup. Minimum five year results wrist arthroplasty in this series reveal a functional range of motion and good patientreported outcome measures in patients with a functioning implant. Carpal component fixation is a substantial problem in rheumatoid patients, as 45% (9/20) of wrists had undergone revision surgery for a loose carpal component.