Twenty cases of microgeodic disease affecting the hands or feet of children are presented, and the relevant literature is reviewed. Clinical features include chilblain-like appearance and tenderness of the involved digits. Radiographically patchy osteoporosis of the diaphysis and/or sclerosis of the diaphysis and rarefaction of the metaphysis with cortical erosion is evident, often accompanied by subperiosteal new bone formation. Characteristically, this condition occurs in winter and resolves spontaneously within 6 months clinically and radiographically. This lesion appears to result from vascular insufficiency of the hands and feet causing bone infarction secondary to intense vasospasm precipitated by cold.