A knowledge with a thorough understanding of the characteristics of the tumorous conditions of the hand is crucial for accurate diagnosis and appropriate treatment. The lesions are mostly benign; however, malignant lesions often have an atypical presentation and often complicated with inappropriate treatment. Good oncological clearance is the main aim in any sarcoma or malignant lesions, and flexible tissue for reconstruction is important for early rehabilitation and function. On the other hand, in benign soft tissue resection performed with adequate margin will minimize local recurrence which prevents complication leading to poor hand function. The aim of this topic is to share the approach of surgical resection and reconstruction options for optimum function in malignant and benign tumor of the hand.