A 26-year-old man was diagnosed with mycotic aneurysm of the left hand associated with active infective endocarditis. Preoperative arteriography of the hand revealed aneurysm of the radial side of the deep arch of the palmar artery. We approached the aneurysm from the dorsal side of the hand in order to avoid damage to the collateral vascular supply of the superficial arch of the palmar artery and neurological structures. As a result, the aneurysm was excised simply by proximal and distal ligation of the vessel. During follow-up over 14 months, no evidence of recurrent aneurysm formation or ischemia of the fingers has been obtained.