We report twenty cases of posterior interosseous nerve palsy; 6 cases accompanying Monteggia fractures, 3 cases of forearm fractures, one case of neuralgic amyotrophy, postoperation of ganglion, ganglion with epiphyseal osteochondroma of radius head, contusion, open injury, dislocation of radius head, and positioning of forearm respectivery, and 3 cases of unknown origin. The diagnosis of cause and lesion of the palsy requires detail anamnesis, examination, x-ray and EMG studies. Incomplete type showed extention lack of one or two digits only. The palsy accompanying Monteggia fractures should be treated by reduction or neurolysis before irreversible changes occur.