Since Kienböck’s, 1910, described osteonecrosis of lunate, many authors written about Kienböck’s disease and despite the constant efforts, the etiology of Kienböck’s disease is unknown and the treatment methods are controversial. The factors influencing lunate necrosis are multiple and a combination of them must be present for the condition to develop. The mechanical factors such as negative ulnar variance, type of load, shape and size of lunate, the vascular factors such as increased intraossious pressure of lunate are contribute to develop the condition. There are other factors such as coagulation disorders, as sickle cell anemia, or inherited hypofibrinolysis and thrombophilia well-known situations associated with osteonecrosis. Long-term steroid treatment is also related to avascular necrosis. Kienböck’s disease usually occurs in adults (20 to 40 years) and is usually symptoms are pain and stiffness and decreased in grip strength force. Also, some patients are given a history of wrist injury. Lichtman et al., 1977, described a clinical and radiographic classification for Kienböck’s disease, which is now widely used. Schmitt et al, 2007 describe classification based on MRI findings. Bain et al, 2006, describe classification based on arthroscopic findings. There are many options for treatment of kienbock’s disease. Conservative management by cast for 3 months tried in early stages but give poor results. Surgical intervention used in late stages when conservative treatment failed. Joint leveling procedures ,bone graft and external fixation, capitate shortening , vascularized bone graft, lunate excision with or without arthroplasty, limited intercarpal fusion, proximal row carpectomy ,total wrist arthrodesis ,wrist denervation ,carpal tunnel release are used in treatment of Kienböck’s disease . Future modalities of treatment of kienbock’s disease such as custom-made micro vascular lunate bone reconstruction, Arthroplasty of the lunate using bone marrow mesenchymal stromal cells may be the future of treatment of Kienböck’s disease.