Objective: Despite its relative high frequency; the recurrence, metastasis and long-term survival rates of hand squamous cell carcinoma have not been well defined. The aim of this study was to review a large cohort of patients with hand squamous cell carcinomas and to evaluate the management techniques, outcomes of treatment modalities and survival rates. Methods: A retrospective review of all surgically excised primary squamous cell carcinoma of the hand operated between 2006 and 2011 was included in this multicenter study. Patients were evaluated regarding age, anatomic location of the tumor, gender, treatment modality, survival, and recurrence rate. In addition, recurrence and survival rates were also categorized according to the tumor size. Results: A total of 129 patients were evaluated. Tumors smaller than 2 cm had a recurrence rate of 9.7% and a metastatic rate of 6.5%; tumors larger than 2 cm had a recurrence rate of 16.7% and a metastatic rate of 33% during 5-year follow-ups. Conclusion: In contrast to squamous cell carcinoma of the face, those occurring on the hand are malignancies with a worse clinical course, greater tendency for recurrence, metastatic spread, and functional deficiency which might require amputation and complex soft tissue reconstruction.