Background <p>The body frequently defends itself against burns through the upper extremities. Hand injuries are serious injuries that can result in catastrophic hand injuries, partial or total amputations, and loss of function of one or both hands. This retrospective, descriptive, observational study aimed to determine the epidemiology, clinical characteristics, and sequelae of patients with catastrophic hand secondary to burn injuries.</p> Methods <p>This descriptive, retrospective, observational study included patients diagnosed with catastrophic hand injuries secondary to severe burn injuries. Electronic file databases were used, and the records of 45 patients treated at our center between March 2021 and March 2023 were examined.</p> Results <p>Among the 45 patients with catastrophic hand injuries secondary to burns, 17 (37.77%) exhibited an acceptable hand, seven (15.5%) had an unbalanced hand, 11 (24.4%) had a crippled hand, eight (17.7%) had a mutilated hand, and two (4.4%) were diagnosed with metacarpal hand conditions. Among patients with severe burn injuries, 23 (51.11%) had electrical burns, 20 (44.44%) had burn injuries from fire, and two (4.44%) had burn injuries from chemical agents.</p> Conclusions <p>Electrical burns were identified as the primary cause of catastrophic hand injuries, with the highest incidence observed in patients categorized as having “acceptable hand injuries.” Proper scald treatment prevents mutilation, and metacarpal injuries are rare and have poor prognoses. Level of Evidence: Level IV, risk / prognostic study.</p>