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Osteoid osteoma is a benign bone tumor that usually grows in the long bones of the body and arises from osteoblasts and some components of osteoclasts. It represents the third most frequent type of benign bone tumors, accounting for 11% to 14% of the tumors. The entity usually involves the proximal femur and tibia. It has also been reported in the hand, especially the scaphoid, capitate, and proximal phalanx. The most common symptom is pain, usually during the night, relieved by the use of salicylates and nonsteroidal anti-inflammatory drugs. To date, only 5 cases involving the trapezium have been reported. This article describes a rare case of a large (1.3 cm) osteoid osteoma of the trapezium in a young male patient treated surgically with resection and curettage of the osteoid and provides a review of the existing literature.