Nodular fasciitis is an uncommon, benign myofibroblastic soft tissue tumour. It is infrequently seen in the hand. A case of nodular fasciitis involving the thumb of a 4-year-old male child is presented. Main significance lies in clinical and pathological recognition of the lesion to avoid over-treatment. Nodular fasciitis remains a difficult diagnosis by fine needle aspiration cytology, particularly when it occurs in locations such as the hand.