Objective To investigate the clinical efficacy of distal oblique bundle reinforcement for the treatment of distal radioulnar joint (DRUJ) instability. Methods The clinical data of 24 patients with DRUJ instability treated with distal oblique bundle reinforcement in our hospital from Jan. 2019 to Jan. 2022 were retrospectively analyzed. The age, surgical site, follow-up time, wrist visual analogue scale (VAS), range of motion (pronation＋supination) of forearm, the quick disabilities of the arm, shoulder and hand (QuickDASH) score before operation and at the last follow-up, and postoperative complications of the patients were collected. The wrist VAS scores and functional indexes were compared before and after operation. Results The average follow-up time was 12-21 (15.38±2.76) months. The wrist VAS score was 4-8 (6.13±1.08) before operation and 1-3 (1.25±0.53) at the last follow-up, showing improvement after operation (P＜0.001). The range of motion (pronation＋supination) of forearm was 95°-145° (120.83±14.35)° before operation and 145°-180° (175.21±6.51)° at the last follow-up, also showing increasement after operation (P＜0.001). The QuickDASH score was 34-98 (78.58±19.22) before operation and was 10-34 (21.46±6.30) at the last follow-up, with significant difference (P＜0.001). One patient had limited forearm pronation and 1 patient had DRUJ instability, which recovered after corresponding treatments. No patients had rejection or infection caused by allogeneic tendon, or important nerve and vascular injuries caused by operation. Conclusion The clinical effect of distal oblique bundle reinforcement is satisfactory, and the incidence of complications is low, indicating it is a safe and effective surgical method for DRUJ instability.