This chapter presents description and analysis of the metacarpals and manual phalanges from Sterkfontein. Although the morphology is generally similar across the sample where there are duplicates of the same element, there are differences in size that are quite remarkable within the context of all South African hominins. Some very large specimens suggest the presence of individuals at Sterkfontein with much larger hands, and presumably larger body size, at Sterkfontein than those of A. sediba MH2, H. naledi and the Swartkrans hominins. Australopithecus africanus had human-like proportions, but this may be plesiomorphic within the hominoid clade. The potentially less mobile trapezium-Mc1 joint, absence of a fully developed palmar pulp on the distal thumb, more limited pronation of the index finger, and potentially more wedge-shaped trapezoid inferred from the preserved external morphology, is consistent with lower manipulative loading of the thumb than is typical of later Homo. As for other forelimb elements, moderately curved manual phalanges suggests a greater reliance on forelimb-dominated locomotor behaviors and perhaps selection for more frequent use of an arboreal environment in A. africanus than is found in A. afarensis. Thus, within this broader context, the Sterkfontein fossil hominin remains are not unusual. The Sterkfontein hand fossils suggest an overall manipulative and locomotor loading regime that was more similar to that of other South African australopiths and distinct from that of later Homo, but more refined functional interpretations require additional fossil evidence, particularly from associated hand skeletons