Many types of wrist outcome instruments are used in the clinical setting to determine the effectiveness of treatment. The authors have previously identified that the individual's perspective and the use of compensatory mechanisms are important factors to consider in the measurement of outcome following a wrist disorder. No published wrist outcome instrument currently addresses these factors, however. Therefore, the aim of this study was to develop a wrist outcome instrument that assessed, from the wrist-injured individual's perspective, their actual ability to perform activities of daily living following a wrist disorder. This article reports on the rationale and procedures used to construct the new instrument and presents the results of preliminary psychometric testing of the wrist outcome instrument.