Purpose Brachial plexus injuries, particularly those affecting the upper plexus, pose significant challenges in restoring shoulder function, especially with regard to external rotation and abduction. These injuries often result in denervation of the infraspinatus muscle, which is critical for shoulder stability and movement. Standard approaches for reinnervating the infraspinatus, such as direct repair or traditional nerve transfers utilising the accessory nerve, are sometimes not viable due to the extent of nerve damage or anatomical limitations. Methodology In this case series, we present three patients who sustained upper brachial plexus injuries through various mechanisms—a bike accident, a stabbing, and post-operatively after an ACDF—each requiring novel surgical approaches to reinnervate the infraspinatus due to the unavailability of standard nerve transfer options. Results Each patient underwent tailored operative management, including distal accessory nerve, thoracodorsal nerve and triceps nerve transfers and the use of sural nerve grafts, to address their specific injury patterns and achieve functional recovery. Conclusion These three cases outline alternate operative management strategies aimed specifically at reinnervating the infraspinatus muscle, when the nature of the injury pattern required a novel approach. Each patient achieved meaningful functional gains, highlighting the fact that each alternate strategy has the potential to achieve a satisfactory outcome for the patients less typical upper brachial plexus injury. These techniques described in this series can all be considered in patients requiring infraspinatus reanimation when typical distal accessory to suprascapular nerve transfer is unavailable.