Manual dexterity and hand functional difficulties in daily life in hand-arm vibration syndrome (HAVS) were investigated in 29 male patients with HAVS and 30 male controls without occupational exposure to hand-arm vibration. Manual dexterity was assessed by measuring the performance time of picking up and transferring 30 red beans, one by one, from one plate to another. Vibrotactile perception thresholds at 125 Hz and grip strength were also examined. Hand functional difficulties in daily life were surveyed with a questionnaire. The HAVS patients had an increased vibrotactile threshold, decreased grip strength, and low performance in transferring beans. Low performances with transfer times over 53 s (2SD from the mean in the controls) were found in 66% of the HAVS patients and 3% of the controls. Bean transfer times in the patients were correlated with an increasing vibrotactile threshold and decreasing grip strength. The transfer times of the patients were also associated with hand functional difficulties such as picking up coins, turning the pages of a newspaper, buttoning clothes, and pouring from a teapot. The patients with a prolonged transfer time over 60 s (3SD from the mean in the controls) were most likely to have hand functional difficulties. The present findings suggest that measurement of the bean transfer time will serve to assess manual dexterity among HAVS patients, and that impaired manual dexterity in patients may be associated with impaired sensory feedback and muscular dysfunction in the fingers and hands.