An improved low profile ratchet wrench comprising a rotatable head and a handle, wherein a lever projecting from the free end of the handle permits selective adjustment of the unidirectional rotation of the ratchet wrench. The lever eccentrically rotates so as to urge a cam and cam teeth to engage the teeth of a ratchet wheel, thereby selecting an appropriate unidirectional path. In use, the unidirectional path may be changed by eccentrically rotating the lever in the opposite direction previously selected, thus permitting reversal of the ratchet head.