Schrock and colleagues first described the clinical use of the atriocaval shunt in 1968. This was done after an exhaustive autopsy review to define the anatomy of the hepatic veins. Fortunately, these are rare injuries. This rarity, however, makes obtaining and maintaining the skillset necessary to perform this procedure challenging. Simulation and video education are vital tools to help surgeons obtain and maintain the skillset for rare procedures. Therefore, the purpose of this video is to provide a step-by-step demonstration of the creation of an atriocaval shunt.