Osteoarthrosis of the trapeziometacarpal joint is a common condition, especially in middle-aged women, and this review summarises the diagnosis and treatment modalities. Many patients have few symptoms and may be treated conservatively with orthoses, nonsteroidal anti-inflammatory drugs and intra-articular steroid injections. In patients with more persistent symptoms, surgical treatment has generally shown good results. Several surgical procedures have been described, but at present, trapeziectomy is the preferred treatment. Total joint arthroplasty is possible and may provide faster rehabilitation and a better grip strength but at the expense of a relatively high risk of implant failure.