Proliferation of the concert repertoire for piano left-hand in the early 20th century is predominantly accredited to the one-armed pianist Paul Wittgenstein. Resolved to cultivate a musical career despite the amputation of his right arm in WWI, Wittgenstein commissioned some of the most eminent composers of this period, including Ravel, Prokofiev, Britten, Korngold, Schmidt and Richard Strauss. Despite Wittgenstein’s unalloyed espousal of conservative music, he often chose progressive composers to promulgate his career; an enigmatic decision which remains unsolved. Wittgenstein’s disability and opinionated nature provided a myriad of compositional obstacles culminating in a profound overhaul of stylistic, musical, technical and orchestral approaches for the composers he approached. His career and commissions construct a consequential portrait of the rarefied art of left-hand piano championed by Wittgenstein, depict the demands of this type of performance and the delineate the impact of his disability on his public reception in the early to mid – 20th century. Academic inertia on this topic was largely due to the inaccessibility of the scores, but with the auction of the Wittgenstein archive by Sotheby’s in 2002, many of these works have filtered into the public arena. Generalised inventories of his life and works have been undertaken, but little scholarly analytical work has been carried out on the musical riches he bequeathed us. Consideration of the genre of left-hand piano as a whole, its technical requirements and tropes, has likewise eluded substantial academic consideration. The composers under review in this thesis: Ravel, Prokofiev and Britten, each expounded a disparate sense of musical modernity, all in opposition to Wittgenstein’s own taste. An exploration of the varying approaches to this unique compositional challenge is pertinent not only to our understanding of these venerated composers, but crucial to our growing comprehension of the genre of left-hand piano. The unique transactional relationship between the composition and performance of a left-hand work, moulded decidedly by the physical restrictions of one-hand at the piano, require the consideration of both aspects, and their relationship to one another in order to understand more comprehensively the extraordinary technical demands and compositional idiosyncrasies of left-hand piano. The central part of this thesis reviews these left-handed concertos in the context of each composers individual output, and ascertains through comparative study of earlier works, the incorporation and exposition of new left-hand techniques. Common structural, technical and musical elements employed by the composers in question are identified to work towards a more defined understanding of the external and internal workings of the left-hand piano genre.