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Distal nerve transfers have proven to be an important addition to the armamentarium for reconstruction of peripheral nerve injuries. As new nerve transfer procedures are developed, the indications for their use continue to broaden. We report a case of a 77 year-old male who had a 9 centimeters long gap of the median nerve after suffering from an avulsion injury to his right forearm. This was successfully treated by transferring superficial radial nerve to the median nerve at the carpal tunnel level, thus restoring thumb, index and first web sensation. Our report emphasizes that nerve transfers in the emergency setting may be the treatment of first choice in cases were conventional nerve grafting is known to result in poorer outcomes such as in long nerve gaps or in the elderly patient population.