In diverse interaction processes that characterize music experience, the human hand can be seen as a mediator and facilitator for the brain's processing of musical expressive patterns. After a brief overview on the human expressive system for music, we consider gestures and hand articulations in music production and performance, focusing on hand dexterity and hand dystonia. Then, we discuss the role of the hand in music listening, conducting, and learning, showing that both in sound-generation and sound-accompaniment the hand mediates and facilitates action and perception in relation to musical expression. The recent use of technology in the domain of music is also considered throughout the chapter, with particular reference to sensing and motion technologies that allow users to control music parameters through hand–body movements. The hand can be considered as a co-articulated organ of the brain's action–perception machinery. Therefore, future research on hand and music should adopt a multiperspective approach that integrates different disciplines, from motor control to music performance and expression theories.