Osseointegration and targeted muscle reinnervation (TMR) offers compelling improvement in amputee patients quality of life, independent living and functional outcomes. Patients who have previously been unable to wear a standard prosthesis due to high level of injury can now be fitted with osseointegrated myoelectric prosthesis to return function to the effected limb. We present the case of a 62-year-old male who underwent successful osseointegration of a myoelectric prosthesis with immediate TMR to his right upper limb in the setting of high traumatic limb amputation from a motor vehicle accident.