The Hand of Benediction is said to have originated from the first pope, Saint Peter, who suffered a neurological condition that caused a unique posturing of his fingers. In medical literature, the Hand of Benediction is described a pathological hand posture consisting of the extension of the index and middle fingers, abduction of the thumb, and flexion of the ring and little fingers. However, despite being extensively documented, the precise location and nerve responsible for this clinical sign has remains contentious. Classically described as a median neuropathy, other anatomists and clinicians have advocated for an ulnar nerve neuropathy as the underlying aetiology. The Hand of Benediction has become archetypical in the western culture as the Latin gesture of benediction with evidence of the posture omnipresent throughout Catholic literature and art. This presentation will review the history of the sign, its relevant and controversial patho-anatomy The history of the Hand of Benediction is intertwined with the broader history of neurology, orthopaedics, and medical imaging. Advances in medical science and technology have contributed to a better understanding of the underlying causes and effective management of this distinctive hand deformity.