Hand lipomas are rare in the hand, and they account for less than 1% of tumors. Osteolipoma is a rare variant of lipoma that is associated with bone metaplasia. It presents as a painless tumor that can cause symptoms when compressing adjacent structures. Magnetic resonance imaging (MRI) is the imaging study of choice. The treatment is surgical resection, with no recurrences being reported. We present the case of a patient with a giant subfascial hand osteolipoma, which, to the best of our knowledge has not yet been reported in the literature.