This article reads as a book chapter, providing an overview of the different aps available to cover soft tissue defects in the hand. It starts off by providing a general introduction to the functional and anatomical differences of the hand, and lays a foundation to the basis of the different tissue coverage for soft tissue defects of the hand. The article then continues to expand on the different options available based on the tissue defect, starting from local flaps to free flaps. The authors assume a level of prior knowledge on the different techniques available and focuses instead on the clinical indications and contraindications. This is also helpfully summarized in tables throughout the article, which serves as a good summary for the readers. The bulk of the discussion was based around the different local aps available with options for free aps given as a list. The authors end the paper by discussing the outcomes of the different flaps based on available literature, where possible including both functional and aesthetic outcome. Clinical pictures, taken pre-, intra- and post-operatively are also included, which helps to illustrate certain clinical points. In summary, this article provides a general overview with regards to the different aps available to reconstruct soft tissue defects of the hands, especially with regards to local flaps. It is a very useful basis for further reading.