The analysis of musculoskeletal stress marker (MSM) development is a commonly employed tool in osteological surveys and is used to infer patterns of occupational activity and societal organisation in archaeological populations. Although the majority of research into upper limb MSMs has focused on the bones of the arm, the bones of the hand have been conspicuous by their absence. This is likely to be due to methodological issues surrounding the study of hand bones and a presumed lack of variation in MSM development in this area. To date, there have been no systematic studies investigating the presence and variation in MSM morphology for the muscles of the human hand. To address this issue, a presence/absence scoring system was developed for twelve sites of muscle origin and insertion in the metacarpals and phalanges, which was used to determine bilateral asymmetry in the hands of 31 individuals from the Naval Hospital Cemetery site in Greenwich, London. Analysis found observable variation in MSM development between and within the hands, which could be used to determine patterns of asymmetry within the sample. Comparisons with MSM scores from the humeri of these individuals indicate a differentiation in MSM development and asymmetry between these anatomical regions. Levels of asymmetry in the hands and humeri were generally low, with only the dorsal interossei displaying statistically significant asymmetry. Subsequent upper limb MSM research will benefit from the inclusion of data from the hands. These results do not support the continued use of the humerus as a proxy for MSM expression across the upper limb as a whole and suggest that important information regarding behavioural asymmetry in the hands is being lost because of the continual exclusion of this anatomical unit from MSM research. Copyright © 2011 John Wiley & Sons, Ltd.