BACKGROUND Aneurysmal bone cysts are an uncommon form of benign primary bone tumors; affection of the hand is very rare. METHODS A rigorous review of the literature showed that this type of tumor has not previously been described in the pisiform. In this article, we report the occurrence of an aneurysmal bone tumor in the pisiform of the left hand of a 19-year-old male. RESULTS This tumor was successfully treated through surgical excision with an uneventful recovery. We describe the process behind the diagnosis of the lesion and the subsequent treatment in an attempt to highlight the rare but possible occurrence of aneurysmal bone cysts in the pisiform. CONCLUSION Appropriate treatment of aneurysmal bone cysts in this location is required, due to the anatomical nature of the pisiform itself with the risks of pathologic fracture and ulnar nerve compression.