Elbow osteoarthritis is less common than osteoarthritis of weight-bearing joints such as the hip and knee. However, it remains an important clinical entity that may cause substantial pain, restricted range of motion, and functional impairment, particularly in posttraumatic cases and in individuals exposed to repetitive upper-extremity loading. Treatment planning should take into account the etiology of the disease, the severity of degeneration, the patient`s age, activity level, and functional expectations. In the early stages, management is primarily based on conservative measures, including nonsteroidal antiinflammatory drugs, activity modification, physical therapy, splinting, and, in selected cases, intra-articular injections. In patients who fail to respond to conservative treatment, surgical options should be considered. In early- and midstage degeneration, arthroscopic debridement and capsular release represent effective treatment options, particularly in cases characterized by mechanical impingement, osteophytes, loose bodies, and capsular contracture. In patients for whom arthroscopic treatment is insufficient or not indicated, the open column procedure may provide meaningful improvements in range of motion and function. In younger, active patients with more advanced articular surface damage who are not suitable candidates for total elbow arthroplasty, distraction interposition arthroplasty constitutes an important nonprosthetic salvage option. Arthrodesis, in contrast, is currently reserved only for selected cases as a final salvage procedure. In conclusion, non-prosthetic treatment strategies for elbow osteoarthritis may provide successful clinical and functional outcomes when appropriate patient selection is ensured.