The Krukenberg procedure was performed unilaterally on four juvenile amputee patients with congenital bilateral absence of the hands. These four cases are reported. The opposite extremity was fitted with a standard prosthetic prescription as an assistive hand. In all cases, the Krukenberg stump became the leading hand. The results have been remarkably rewarding to these patients. There has been virtually no concern evidenced by the patient or the parents about the appearance of the stump. The surgical procedure is considered to be reasonably uncomplicated. Postoperative rehabilitation has been simple and rapid. It is my impression, from observing these patients, that this procedure should be extended to more individuals who have the severe handicap of bilateral hand loss.