Glomus tumors of the hand are benign lesions that historically have often eluded a timely diagnosis and effective therapy. The reason for this difficulty in diagnosis lies partially in the rarity of these lesions. A certain degree of suspicion as well as a knowledge of the appropriate workup are necessary. In this article we submit an algorithmic approach to the diagnosis and treatment of these lesions as a guideline for clinical management. A description of our preferred method of extirpation is provided.