Idiopathic avascular necrosis (AVN) of the capitate is rare. A 44-year-old woman presented with chronic pain in her dominant wrist without a history of trauma. Clinical and standard radiological examination were initially inconclusive, while MRI was diagnostic. Mid-carpal arthrodesis gave a satisfactory short term result, and the long term result is awaited. Idiopathic AVN of the capitate should be included in the differential diagnosis of chronic wrist pain.