The role of the hand as the primary form of interaction with the surrounding physical environment is often underappreciated, and injuries to it can become especially debilitating. The hand has evolved into a complex, intricate structural conglomeration of bones, joints, tendons, ligaments, and neurovascular structures, with an overlying soft tissue envelope that is varied and adapted to particular functions. Wounds to the hand requiring flap coverage warrant careful planning. Increasing knowledge of anatomy has led to the description of many flaps. This article presents a review of the commonly used flaps in reconstruction of the hand and the various considerations involved.