Nontuberculous mycobacterium (NTM) are emerging as an important pathogen that merit close attention from clinicians around the world. Musculoskeletal NTM infections are most commonly found on the hand. In spite of appropriate clinical care including surgery and admin-istration of antibiotics, recurrence of NTM infection of the hand is frequent and multiple operations may be required. Consequently, repeated surgeries can cause soft tissue defects that require reconstruction. This report suggests that when NTM infection of the hand re-quires not only antibiotic treatment and simple surgery but also reconstruction, the dorsal metacarpal artery flap can be considered for proximal palmar and entire dorsal surface coverage of fingers.