This video describes the indications for, the technique for, and a case series on transverse metacarpal shaft fractures managed via single antegrade intramedullary Kirschner wire fixation. Various surgical techniques have been described for the management of metacarpal shaft fractures, including intramedullary rods, crossed Kirschner wires, transverse Kirschner wires, dorsal plates, cerclage wires, external fixation, and headless screws. These fixation options are associated with varying outcomes with regard to fracture healing, stabilization, and complications. Intramedullary fixation with the use of a single antegrade Kirschner wire may be associated with decreased healthcare costs. Our technique is reliable, safe, and cost effective for the management of transverse and short oblique metacarpal shaft fractures.