This article outlines the historical development of midcarpal instability observations and terminology and places them in the broader context of currently accepted theories of wrist pathomechanics. Such an understanding may help resolve the following questions: Are there 1 or more entities under the current designation of midcarpal instability? What are the underlying pathogenesis and pathomechanics of the disorder(s)? What are the recommended treatment options? What further research needs to be done to better answer these questions?