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Background and purpose: There are several surgical techniques described to restore elbow flexion in brachial plexus injuries with a late presentation. Among these, Steindler flexorplasty is a method with good outcomes and few complications. To date, no reports of chronic median nerve neuropathy as a complication of the procedure are known. Case description: The current case report presents a patient that developed paresthesias of the median nerve territory after a Steindler flexorplasty, with documented chronic nerve injury on electromyography. Implant removal and neurolysis were performed with functional improvement. Conclusion: Median nerve injury was caused both by screw head prominence and the large size of the bone graft.