Upper extremity surgery in cerebral palsy (CP) is one of the important topics of hand surgery. Children with CP need lifelong treatment from the time of diagnosis. Although the neurological symptoms do not progress, joint contractures develop due to the contraction of the overactive muscles as a result of the growth of the musculoskeletal system and the contracture of the muscles. Differences of the upper extremity with respect to the lower extremity should be taken into consideration in patients with CP. More and smaller muscles contain finer functions and are more affected by emotional factors because they are more visible than the lower side. While the patient is happy to be only mobilized with the lower limb, he/she may have fine functions and cosmetic demands in the upper limb. For this reason, expectations are high in surgical treatment on the upper side and more attention should be paid. The physical therapist, physiotherapist, pediatric neurologist and surgeon should make a joint decision if possible. Surgical treatment should not be indicated at first sight, and a decision should be made after adequate observation.