Abstract
Background:  Thumb hypoplasia is a congenital underdevelopment of the thumb, accounting for 5% to 15% of congenital hand disorders. It occurs equally among both genders and can affect both thumbs. The condition is categorized using Blauth’s classification with type I being the mildest form.
Case Presentation:  We report a 23-year-old Syrian male presented with a bilateral restriction in opposition movement when using a pen or razor. Clinical examination and x-ray imaging revealed a bilateral type I hypoplastic thumb with bilateral minimal hypoplasia of the toes. Despite the surgical treatment options available, the patient opted not to undergo surgery due to his adaptation to his condition.
Conclusion:  Hypoplastic thumb type I is a congenital condition characterized by underdevelopment of the thumb. Bilateral thumb hypoplasia with toes hypoplasia is extremely rare. A full systemic evaluation should be done due to its associations with other syndromic manifestations and treatment options are discussed concerning the best functional outcomes and patient preferences.