In the century since it was first described, much has been learned about Kienböck's disease. However, despite advances in diagnosis and treatment, questions remain regarding the etiology of this condition. In this discussion, we will review the history and rationale for the current classification system, along with our current treatment algorithm. Additionally, we will discuss emerging classification systems based on new technology that enhances the understanding of Kienböck's disease. With consideration of this new information, we will propose new stages of this condition, and speculate on how these new stages may affect the future of Kienböck's disease.