Fractures involving the short tubular bones of the hand are the commonest. Neglected fractures may be defined as those which have not received any or proper treatment for the initial period of two or more weeks. The treatment of neglected hand injuries differ from those of fresh injures since the former is usually associated with deformities, stiffness and tendon adhesions. Neglected fractures and dislocations result due to ‘missed’ injuries at the initial examination, untreated injuries due to carelessness or ignorance, treatment received from a ‘quack’ or masseur or a polytrauma patient where more severe injuries take priority. In late presentation of distal phalanx fractures, malunion is usually apparent. Corrective osteotomy may be helpful for severe angulation as well as rotational deformities causing difficulty in hand function. Angular and combined angular and rotational deformities of the proximal and middle phalynx may require corrective osteotomy with derotation when needed. Intra-articular fractures of the DIP joint detected late may be treated with inter-condylar wedge resection combined with a sliding osteotomy of the fracture with its proximal supporting cortex. Intra-articular fractures of the PIP joint presenting late usually requires arthrodesis in functional position or treatment with external hinge distraction system (EHDS). Most of the metacarpal malunions are mild and do not justify any operative intervention. Symptomatic intra-articular malunions are usually salvaged by arthrodesis or arthroplasty. Neglected dislocations of the MCP joints require open reduction either through a dorsal or volar approach. Proper evaluation of patients need, deformities and functional expectations is a must before embarking upon the treatment of neglected hand injuries.