Patients with Apert syndrome invariably present with degrees of complex syndactyly of all four limbs. Though optimizing hand function has historically been considered a secondary concern, we view it as an integral care component. This group of authors’ approach to surgical treatment of the Apert hand may involve various procedures tailored to the individual patient to refine patients’ hands and ultimately promote long-term well-being and quality of life benefits. Beyond syndactyly release, adjunct procedures, including central coalition osteotomy for Type III hands, osteotomy or distraction lengthening to align and lengthen the thumb, phalangeal augmentation, and correction of angular deformities of the digits may be offered later in childhood to improve function and appearance. Through comprehensive evaluation (often beginning before birth), a staged plan for reconstruction, meticulous surgical technique, and vigilant long-term monitoring, highly favorable results in treating all types of the Apert hand can be achieved.