Background: Hand mutilation due to burn injury has its own lifelong imprints. The resultant contracture needs meticulous and aggressive management by a team consisting of Plastic, Reconstructive, Hand, Orthopedic Surgeons and Physiotherapist. The objective of this study was to assess the frequency of hand mutilation secondary to burn injury and to evaluate the treatment options for its management. Methodology: This prospective observational study was conducted at Department of Plastic Surgery and Department of Orthopedics and Traumatology, Liaquat University of Medical & Health Sciences, Jamshoro over the period of two years from January 2008 to December 2010. A total of forty patients were included in this study after obtaining informed consent. Results: Male female ratio was 2.1:1. Age ranged from 1-40 years. Most of patients were children. Majority of patients belonged to rural areas and were uneducated, with lower socioeconomic status. Accidental flame thermal injury was most frequent. Most patients presented with mild to moderate type of contracture. Hand function improved better with full thickness skin graft. Major complications were local infection and graft failure. Conclusion: Most of hand mutilations are preventable or could be reduced considerably in severity by proper initial post burn splitting, positioning, early surgery and rehabilitation of hand.