The aim of this review was to present currently available evidence on the management of acute scaphoid fractures. Acute scaphoid fractures are usually diagnosed by a combination of history, physical examination, and radiography. However, in many patients scaphoid fractures are still missed. Thus, the general trend is to over-treat patients with a suspicion of scaphoid fracture. Many aspects of scaphoid fracture management are still controversial and different institutions vary in their approach.