Carpal coalition is not an uncommon entity. It is most often asymptomatic and coincidentally noted on roentgenograms. The most common location is between the lunate and the triquetrum, although nearly every combination has been reported. Reported is a 33-year-old man with a symptomatic scapholunatotriquetral carpal coalition associated with capitatometacarpal coalition. This condition seems not to have been previously reported in the literature.