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The medial ulnar collateral ligament (MUCL) is commonly injured in the elite overhead throwing athlete. Many techniques have been described to reconstruct the ligament in an effort to return the athlete to play. A recent anatomic study detailed the broad ulnar attachment of the MUCL. Reconstruction of the ligament across the entire ulnar footprint has not previously been described. The senior author’s technique for anatomic MUCL reconstruction recreates the broad ulnar footprint of the native ligament.