The loss of upper extremity function following an interscapulothoracic amputation is unquestionably significant. Historically, the prosthetic rejection rate at this level of amputation has been high, due to reasons such as increased energy expenditure, increased weight, increased warmth, decreased socket comfort, poor suspension, and inadequate function. We have successfully implemented a seven-step prosthetic treatment protocol for interscapulothoracic cases. The protocol being the initial evaluation, preprosthetic training, component selection, socket design, alignment and construction, customized programming, and initial training with the prosthesis.