Abstract—The occurrence of primary neural tumors in hand is relatively rare accounting for less than 5% of soft tissue tumors of hand. Neurilemmomas are the most common primary tumors among the peripheral nerve sheath tumors (Holdsworth, 1985; Phalen, 1976; Strickland et al., 1977; and Whitaker et al., 1976). Pre-operative diagnosis is possible in less than 1% of cases (Kehoe et al., 1995). Though dumbbell shaped tumors in spinal cord have been known to occur commonly, dumbbell shaped neurilemmoma of hand have not been reported. Here we report a case of dumbbell shaped neurilemmoma of hand with a small component above the palmar aponeurosis and large component deep to it, which was diagnosed pre-operatively with MRI and was successfully removed surgically with magnification.