Markers placed along palmar skin creases of 53 hands radiographically demonstrated creases superimposed on osseous anatomy. The distal and middle digital creases were found to be consistently proximal to associated interphalangeal joints by 7 to 8 mm and 2 to 3 mm, respectively. Proximal digital creases were consistently distal to associated metacarpophalangeal (MCP) joints by 14 to 20 mm. Distances between the distal transverse palmar crease and associated MCP joints were 6.8 to 10.3 mm. Distances between the proximal palmar crease and the associated MCP joints were 9.1 to 22.1 mm. Mean perpendicular distances between the distal wrist crease and center of selected carpal structures or joints were as follows: scaphoid, 0.7 mm; pisiform, 3.4 mm; lunate, 9.2 mm; hamate hook, 12.6 mm; ulnar styloid, 11.7 mm; trapeziometacarpal joint, 19.4 mm; radioscapholunate joint, 13.5 mm; and distal radioulnar joint, 21.1 mm. Quantification of these relationships should assist in hand examination and placement of surgical incisions and provide further insight into anatomic and functional relationships of the hand.