Localisation of tuberculosis in the hand is a rare entity. We report here on 45 cases representing 7% of 650 cases of tuberculosis of the musculoskeletal system treated in our clinic during the past 16 years. Localisation in a joint or tendon sheath is classic but some others such as osteitis (8 cases) or soft tissue lesions (3 cases) have been seen, so the diagnosis must be proved bacteriologically by demonstrating the presence of the tubercle bacillus or, more often, histologically. A prolonged clinical course before the patient seeks medical advice is common and the clinical manifestations are numerous. Some patients were treated with a classical one year regimen. More recent cases have been treated with a short six month regiment. A comparison of the effectiveness of the two regimes is made.