BACKGROUND: Hand injuries are common in this environment. They are rarely life threatening but can cause serious handicap with far reaching consequences. There is however paucity of studies addressing the management of hand injuries in this country. The aim of the study was to evaluate the pattern of presentation and management of hand injuries, and to determine the immediate outcome and factors that may influence outcome. MATERIAL AND METHODS: It is a one year prospective and descriptive study (July 2011 to June 2012). All consecutive patients with hand injury that presented to the emergency and outpatient departments of the hospital within the period and met inclusion criteria were recruited into the study. Information obtained included biodata, hand dominance, cause and time of injury, examination and operative findings, treatment given and immediate outcome. The data were analyzed using the SPSS (17.0). Chi Square test was used to determine the significance of factors that influenced outcome. Results were presented in tables (frequency and percentages), bar and pie charts using Microsoft Excel 2007. RESULTS: 120 patients presented with hand injuries, representing 5.5% of the total number of patients that were seen at the emergency department. Twenty patients were excluded from the study. 78% of patients who met inclusion criteria were males and 22% were females with mean age of 26 ±16.8yrs, a range of 0.75 - 80yrs and peak of 20- 29yrs. Students were most commonly affected (25%). The most common cause of hand injuries was domestic accident (28%), followed by work related/ industrial accidents (25%) and road traffic accidents (22%). Fireworks resulted in 6% of injuries. The most common types of injuries were crush injuries with 24% and lacerations with 23%. 9% presented with gangrene. The mean injury severity score was 37.8 ±45.9 with mild injuries being the most common form of injuries. 75 patients had surgery while 25 were managed conservatively. Immediate outcome was excellent in 32% of patients, good in 40% and poor in 28%. The outcome was influenced by the type of injury based on the mechanism, the nature of wounds, and injury severity. CONCLUSION: Hand injuries are common and show slight variation in pattern in this environment. Efforts should be made to reduce the incidence and improve management outcome.