Radiological hand skeleton diagnostics has been a standard field for studying developmental disorders in the broadest sense for about 60 years. It followed the anatomical era, which had detailed the varieties of hand skeleton development down to subtle details, without being able to precisely outline the norm. Most of the anatomical and radiological treatises listed chronologically below focus on establishing norms and ranges of variation: Gruber 1866; RnIB, CD, and RDAuLT 1864; Pfitzner 1895; V. Ranke 1896, 1898; Heimann and Potpesch 1907; Rotch 1908; Stettner 1921/22, 1931, 1935; Hasselwander 1921; Gött 1924; C. Rter 1926; Munk 1927; Baldwin 1928; Hellmann 1928; Sawtell 1929; Ckita and Hatai 1929; Rückensteiner 1931; Kamerling jr. 1932; Pryor 1935; Flory 1936; Korxfel 1936; Siegert 1937; Todd 1937; Pyle, Dreizen, and Mann 1948; Schmid, F. 1948; Giehllich-Pyle 1950. Only a few of these works address the clinical significance of ossification studies or specific clinical questions. In an initial summary (F. Schmid: The ossification of the hand skeleton as an indicator of development, 1948), an attempt was made to systematically evaluate hand skeleton development. This presentation was based on material from over 1700 cases. The present atlas can not only draw on a larger body of material but also encompasses a further clinical and developmental biological framework through a now 12-year collection. The study is divided into an atlas section and a clinical-diagnostic section. The atlas section contains information on norms and variations concerning age, sex, and body size. Corresponding overview tables are included.