This is a case report of a congenital hemangioendothelioma-a rare vascular tumor of the hand. The literature concerning hemangioendothelioma has numerous conflicting statements as to histologic definition, malignant potential, and optimal treatment. A newborn found to have a hemangiomatous type of lesion on the index finger of the right hand was operated upon at 7 days of age. An intraoperative brachial arteriogram identified the radial digital artery as the major arterial supply to the lesion. The operating microscope allowed precise dissection and preservation of the digital nerves and the flexor and extensor tendons. The defect was covered with a full-thickness skin graft providing optimal follow-up for local recurrence.