Brachial plexus birth injuries occur at a frequency of 1-2 per 1000 births. Many of these injuries spontaneously resolve. Should spontaneous recovery not occur within the first 4-6 months of life, the prognosis for attaining movement and function of the affected appendage is significantly impaired. The child demonstrates a lifelong disfiguring and functional handicap. With advances in technology, diagnosis and microsurgical techniques, surgical exploration of the brachial plexus has been revived. A multidisciplinary approach has provided dynamic results. At present only one institution in the United States utilizes this innovative protocol. This article addresses the collaborative perioperative nursing implications for a child with brachial plexus birth injury.