A clinicomycological study of 20 cases of mycetoma of upper extremity has been undertaken. Eleven of these had lesion in the hand and the rest were affected in the forearm (3), elbow region (2), axilla (2) and shoulder region (2). M. mycetomi was the most common causative agent. Other fungi identified were M. grisea, Streptomyces somaliensis and Streptomyces madurae. The infection was found commonly in farmers in the age group of 16–45 years. The classical triad of swelling with sinuses discharging granules and history of thorn prick were not necessarily present in all cases. In three patients the underlying bones were also involved. Local excision under tourniquet was the treatment of choice unless bones were involved.