The surgeon Ambroise Paré designed an anthropomorphic hand for wounded soldiers in the 16th century. Since that time, there have been advances in technology through the use of computer-aided design, modern materials, electronic controllers and sensors to realise artificial hands which have good functionality and reliability. Data from touch, object slip, finger position and temperature sensors, mounted in the fingers and on the palm, can be used in feedback loops to automatically hold objects. A study of the natural neuromuscular systems reveals a complexity which can only in part be realised today with technology. Highlights of the parallels and differences between natural and artificial hands are discussed with reference to the Southampton Hand. The anatomical structure of parts of the natural systems can be made artificially such as the antagonist muscles using tendons. Theses solutions look promising as they are based on the natural form but in practice lack the desired physical specification. However, concepts of the lower spinal loops can be mimicked in principle. Some future devices will require greater skills from the surgeon to create the interface between the natural system and an artificial device. Such developments may offer a more natural control with ease of use for the limb deficient person.