Introducing and implementing an arthroscopic classification tool for posterolateral elbow instability. Thirty arthroscopies were performed on 30 patients, and all recordings were collected, blinded, and labeled. Three orthopedic surgeons reviewed and scored all 30 recordings three times with a period of at least seven days in between to analyze the intraobserver and interobserver reliability. The classification consisted of five different grades. Indications for elbow arthroscopy included impingement (n=7), osteochondritis dissecans (n=5), pain (n=7), osteoarthritis (n=6), and other (n=5). The kappa value for intrarater reliability was 0.71, indicating good reliability, while the kappa value for inter-rater reliability was 0.38 indicating fair reliability. This new classification is a tool for an arthroscopic assessment of PLRI and can be used as a standardized grading system for further research and communication between orthopedic surgeons. We demonstrated good intrarater reliability (k=0.71) with fair inter-rater reliability (k=0.38). However, further research is necessary to study the clinical significance.