Vascularized bone graft is a recent improvement in the arsenal of the hand surgeon. It can be applied in a wide variety of indications ranging from segmental bone defect after trauma to recalcitrant nonunion. Historically, the most frequent being scaphoid nonunion. This challenging pathology, with a high rate of failure to unite after conventional surgery, has led surgeons to shift from cancellous to vascularized bone grafts. To date, many different techniques have been described, most cited are Zaidemberg or Kuhlmann’s vascularized bone grafts. However, none have shown superiority to the others and none can be applied to more than one or two different surgical indications. The vascularized bone graft from the base of the second metacarpal remains disregarded to the present day. It seems comparable in terms of union rates and can be applied for a wide variety of surgeries. This work reviews the current literature about existing vascularized bone graft that can be applied to the hand with a special interest on the base of the second metacarpal bone. We present its vascular anatomy and possible clinical application including those previously reported. No less than 12 different clinical applications have been listed. With a consistent artery and easy to harvest it makes the perfect versatile bone graft for every situation. Naturally, further scientific literature is needed to confirm the early promising results of this technique as well as its genuine indications.