Introduction: The purpose of this paper is to report the increased incidence of CA-MRSA in hand infections at an urban medical center. Materials and methods: We performed a retrospective review of all patients with hand infections over a 21month period. Demographic data was collected along with risk factors for nosocomial MRSA. Based on chart review, cases determined to be nosocomial were separated from CA-MRSA cases. The study period was divided into three 7-month periods to evaluate the incidence of CA-MRSA. Results: A total of 343 hand infections were treated. 89 patients with culture positive MRSA were identified. 14 patients were determined to be hospital-acquired MRSA patients based on chart review. The remaining 75 patients were determined as CA-MRSA patients. The incidence of MRSA were significantly different during the 3 time periods . During the last 7-month period, a significant increase in CA-MRSA in hand infections was identified. Conclusions: We have found a significant increase in CA-MRSA in hand infections at our center over the last 7 months. We feel this trend may be occurring throughout the US, specifically at urban centers.