Reconstruction of thumb after traumatic or congenital loss in 17 cases is reported. Cases were divided into three groups according to the level of thumb loss. There were two cases in distal zone, seven in middle and eight in proximal zone. Thirteen cases were traumatic in origin and four had congenital loss. Different reconstruction procedures were used at each level. Osteoplastic reconstruction for the middle zone and index finger pollicization for proximal thumb loss are considered to be most useful methods of thumb reconstruction if microsurgical facilities are not available.