Injuries of the hand are common accounting for around a fifth of all emergencies presenting to emergency departments of most hospitals. Their treatment costs. Those that require more reconstruction, theatre time, stay in hospital and after care cost more. In the UK, over 100 million pounds is being spent per year in treating these injuries. However indirect expense to the patients and the consequences of permanent disability are seldom considered. This review discusses the direct and indirect costs of hand injury, the ability of countries to pay these costs and suggests some ways of minimising these costs.