Sea urchin spine injury is usually a benign process that rarely comes to the attention of a physician. Aside from the transient episode of excruciating pain which responds dramatically to hot water soaks, there is usually no residual disability. As in any puncture wound, tetanus prophylaxis and observation for latent infection is advised. Complications arise, however, when spines are embedded over bony prominences, within joints, or in contact with nerves. Cases are reported herein of the latter two problems occurring in the hand. A case of a neuropathy associated with sea urchin injuries has not been previously reported in the literature. When such injuries necessitate exploration, aseptic surgical technique is required.