The Department of Hand and Reconstructive Microsurgery traces its roots back to 1974 when Emeritus Professor Robert Pho, alongside Professor P B Chacha, established the first microsurgical section in Southeast Asia, within the University Department of Orthopaedic Surgery . The team achieved significant milestones in Hand and Reconstructive Microsurgery, including the first thumb replantation in Singapore in 1977, vascularized fibular transfer in 1978, and toe transfer in 1980.
In 1985, the Hand Surgery Unit was officially established at the Singapore General Hospital. When the university staff relocated to the National University Hospital in 1989, Emeritus Professor Robert Pho initiated a hand division within the discipline of Orthopaedic Surgery. On 1 December, 1991, an independent Department of Hand and Reconstructive Microsurgery was formally established. The founding staff included Emeritus Professor Robert Pho as Chief, Professor K Satku and Professor V P Kumar as Consultants, and Mr Kour Anam Kueh as Senior Lecturer and Senior Registrar.

The department was helmed by Associate Professor Lim Beng Hai from 2000 to 2004. The first fully certified hand surgeons to be trained at the department were Dr Looi Kok Poh, followed by Professor Aymeric Lim, who assumed the role of department chief in 2005. In 2008, Dr Peng Yeong Pin took over as chief from Professor Aymeric Lim when the latter was appointed NUH's Chairman, Medical Board.
Under Dr Peng's leadership, the Hand and Reconstructive Microsurgery Centre (HRMC) was established. First in Southeast Asia, the centre was officially opened in April 2011, bringing together staff from the Department of Hand and Reconstructive Microsurgery, Hand Occupational Therapy, and a dedicated team of nursing and administrative staff. The department is currently under the leadership of Dr Sandeep Jacob Sebastin Muttath.