Fractures of the radial head and neck accounts for up to one third of the elbow fractures. Incidence is estimated to be 2.5 to 2.9 per 10,000 per year. In comminuted radial head fracture excision of radial head may lead to loss of strength, valgus instability, & proximal migration of radius leads to wrist pain. Radial head replacement restores normal anatomy and functions of elbow, radioulnar & wrist joints. Radial head fractures with more than three fracture fragments have been shown to be difficult to fix and have a high predilection towards hardware complications, malunions, nonunions, and the need for re-operation after ORIF. In response to these difficulties, radial head arthroplasty is quickly gaining popularity for the treatment of comminuted radial head fractures. A cemented radial head prosthesis may be chosen in order to avoid/reduce the risk of an intraoperative radius fracture, in cases of revision surgery and in cases where rigid fixation is not sufficiently obtained during surgery using a press-fit method but is strictly required. This study includes 20 cases of severely unreconstructable radial head fractures managed by cemented radial head replacement. The cases were operated on at Department of Orthopaedics at Benha University hospital and Shebin El-kom hospital for specialized surgeries between January 2023 to April 2024. Cemented radial head arthroplasty was done for Mason types III and IV fractures and functional outcome was calculated postoperatively with Mayo elbow performance score on follow-up at 3-, 6- and 12-month intervals.