Peripheral nerve injury is amongst the most common causes of acquired temporary or permanent handicap, often necessitating repeated medical interventions. Currently the mainstay of treatment is surgical, however, functional heating rates are low. An enlarging base of knowledge exists regarding the balance of power between molecular factors supporting regeneration and those inhibiting it in the immediate environment of the axon. This knowledge has begun seeping into clinical practice in the form of surgical interventions combined with local molecular treatments, but these developments are just commencing. This article reviews the anatomy of the peripheral nerve, its' natural repair process after injury, current treatment options and future prospects rising from the basic science research.