The primary aim of this prospective study was to assess the healing rate of scaphoid pseudoarthrosis treated with wrist arthroscopy, olecranon bone graft and anterograde screw fixation. Clinical, radiological outcomes and complications were included as secondary aims. All patients with scaphoid nonunion were selected between January 2017 and December 2022. Inclusion criteria were patients between 18 and 60 years of age, diagnosis of scaphoid pseudoarthrosis, complete clinical patient-reported outcomes (PROs), radiographic measurements, and underwent at least 1-year follow-up. Scaphoid pseudoarthrosis was treated arthroscopically with olecranon bone graft and anterograde screw fixation. Clinical assessment was performed through visual analog scale (VAS) for pain, QuickDASH (disability of the arm, shoulder, and hand) questionnaire, wrist range of motion using a standard goniometer, and grip strength in Kilograms with a Jamar hydraulic hand dynamometer. Clinical relevance was measured with the minimal clinical important difference (MCID) for VAS and QuickDASH. Scapholunate angle was measured. Union was assessed on CT scan. Seventeen patients were included with a mean follow-up of 17.2 months. Mean age was 30.1 years old and average time from injury to arthroscopic surgery was 11.1 months. At latest follow-up, there was an improvement in VAS pain score and QuickDASH score. Range of motion and grip strength increased at last follow-up. MCID threshold for the VAS and DASH score was reached by 100% and 94.1%, respectively. Union was achieved in 16 patients (94.1%) after a median of 16 weeks (IQR 16-20). Arthroscopic treatment of scaphoid pseudoarthrosis with olecranon bone graft and antegrade percutaneous headless compression screw allows a high grade of union and improves in pain and function at short term follow-up. MCID threshold for the VAS and DASH score was reached by 100% and 94.1%, respectively.