An unusual case of polydactyly of the hands and feet is described. The ulnar 4 digits of both hands and the outer 4 digits of both feet appeared normal, and the extra digits were on the radial side of the hands and on the medial side of the feet. The pattern of polydactyly did not fit any of the well-known deformities associated with radial digital duplication such as thumb polydactyly, mirror hand, or duplicated (multiple) hands. The harmonious deformities of the hands and feet suggest a genetic alteration to the development of all 4 limb buds, but the case did not fit any of the known syndromes that have high-level preaxial digital duplication of the hands and feet.