Intra-articular distal radius fractures with significant articular step-off and gapping are associated with high risk of developing symptomatic arthritis and poor functional outcome. The use of arthroscopy for distal radius fixation had been well published in the literature. It allows the surgeon to fine-tune intra-articular fragments to achieve articular congruency, address ligamentous disruption, and check for screw penetration within the joint. Various techniques have been reported, including volar locking plate presetting to aid in arthroscopic reduction. Here, we demonstrate our arthroscopic-assisted distal radius fixation technique using a 1.9-mm miniature scope NanoScope (Arthrex, Naples, FL).