Background: The hand is a common site of tumors and tumor-like pathology. This study aimed to evaluate hand tumors and their distribution regarding age, gender, and histopathological characteristics to promote better understanding and aid in diagnosis. Material and Methods: A total of 261 incisional or excisional biopsies for hand tumors were reviewed retrospectively from January 2017 to December 2022 at Princess Iman Research Center. The tumor was assessed according to the tumor origin, and histopathological diagnosis was analyzed regarding age and gender to find the correlation. Biopsies with more than one possible diagnosis and excised hand tumors that were not sent to a pathologist were not included. Results: Soft tissue tumors represented 93.5% and bone tumors 6.5% of all hand tumors. Malignant tumors were reported in 6.1%. Tendon sheath (19.2%) and synovial (17.6%) origin tumors were the most common types, followed by skin (13%) and vascular (12.6%) tumors. Giant cell tumor was the most common hand tumor type (18.8%), followed by Ganglion cyst (16.5%). Enchondroma was the most common bone tumor (3.1%), and squamous cell carcinoma was the most common malignant tumor in hand. There was no difference in the distribution of tumors between different gender and ages. Conclusions: Although ganglion is the most common hand tumor in all reports, in our study, it was the second most common after the Giant cell tumor of tendon sheath because many surgeons depended on the clinical picture alone. Multicenter studies and other study designs, such as clinical and radiological evaluation, are required for a better understanding of the distribution of hand tumors.