The cases of all patients with a diagnosis of giant cell tumor of bone occurring in the hand and seen at the Mayo Clinic during a 50-year period were reviewed to assess the results of treatment. There were 5 lesions in the phalanges, 7 in the metacarpals, and 1 in the scaphoid. The mean duration of symptoms and interval to recurrence were shorter than those seen in giant cell tumor of bone occurring in sites other than the hand. Radiographically advanced disease was common at presentation. Local recurrence was seen after 11 of 14 intralesional procedures (79%) involving curettage or curettage and bone grafting. Local recurrence was seen after 5 of 14 procedures (36%) involving local excision, wide excision, amputation, or ray resection. Lung metastases developed in 2 patients after or concurrent with local recurrence. Local control was most effectively achieved with wide excision or ray resection.