Proximal interphalangeal joint arthroplasty has resulted in good outcomes in patients treated for osteoarthritis, posttraumatic arthritis, and rheumatoid arthritis. Most hand surgeons complete arthroplasties of the proximal interphalangeal joint through a dorsal approach. However, for the past 7 years, we have had positive results with a volar approach. We describe this technique, which avoids injury to the extensor tendon and allows for a more simplified approach to postoperative therapy compared with the therapy regimen required after the dorsal approach.