Soft tissue sarcomas of the hand are rare and challenging neoplasms. Hand surgeon usually comes across one or two undiagnosed cases of synovial sarcoma during their career. The combination of an indolent presentation and the overwhelming predominance of benign hand tumors often lead to a lack of urgency in obtaining a diagnosis and hence delay in treatment. Synovial sarcoma of the hand is notorious for recurrence and metastasis often with devastating results despite apparently complete resection. The decision about the extent of resection requires a balance between the requirement for negative resection margins, which is associated with reduced local recurrence and improved overall survival, and the functional requirement for greater preservation of native tissue, which improves functional outcome. Prompt diagnosis is vital in treating a potentially malignant soft tissue mass.