The human hand is one of the most distinct features that differentiate human from animal, and its difference and efficacy comes from charasteristics of the thumb. The thumb is different from other fingers by its position, having 2 phallanges rather then 3, where the distal one is thicker than the proximal, and the associated metacarpal bone is more mobile than the others. While the most important attribute in other fingers is their mobility, thumb's charasteristic function is due to its stability, length and opposition. Because of these specific characteristics of the thumb, in case of maldevelopement, damage or loss of the thumb, all the human hand's actions are compromised. The importance of thumb reconstruction is clear, even if it means losing some other finger. During planning of the operation many factors are taken in count - the level of damage (in case of trauma) or undeveloped structures (if congenital defect), state of the rest of the hand, of the thenar muscles, and the patient himself - patient's age, proffesion, overall health and requests. In nearly hundred years of striving to achieve the best reconstruction, many methods are described and tried, and this paper will overview ones being used today. Methods include replantation of the amputated thumb, a number of flaps, substitution of thumb with another finger and osteoplastics. Variations in technique lead to different results, making each one more suitable for different defects.