Frostbite injuries are typically associated with soft tissue damage, but deeper structures such as bones, joints, and cartilage may eventually be affected in more than half of all patients. We report a case of a 29-year-old man who presented with bilateral distal and proximal interphalangeal joint pain, decreased range of motion, and an examination and radiographs consistent with osteoarthritis (OA). The symptoms began two decades previously after a frostbite injury sustained to both hands at age 9. This case illustrates some important clinical sequelae resulting from frostbite injury, such as premature OA, Additionally, because the injury occurred before epiphyseal growth plate closure, he also developed brachydactyly. The thumbs were spared, as has also been reported by others, because the thumb is often protected in the palm.