Giant cell tumor of bone uncommonly occurs in the bones of the hands and feet. Previous reports suggested that the giant cell tumors in these locations occur in younger patients, are more commonly multifocal, and are associated with a higher risk for local recurrence and pulmonary metastasis than those at the ends of the long bones. A review of our experience with 43 patients having giant cell tumors in small bones is presented. Radiologic and histologic comparison is made with aneurysmal bone cyst and giant cell reparative granuloma (giant cell lesion) of the small bones. Followup information indicates that giant cell tumors of the small bones do occur in younger patients and appear to have a greater propensity for local recurrence than those of the long bones. As the lesions may be multifocal, a patient with documented giant cell tumor of the small bones should have a skeletal survey to search for other lesions.