The article reviews the administrative and judicial stand on the hand-arm vibration syndrome in Japan and the controversy that has accompanied the topic over the years. As an occupational disease, caused by vibrating tools, the syndrome has officially evolved from a vague entity comprised of neuritis and relevant diseases to that of a peripheral circulatory or neurological or motor-organ disorder involving the fingers, hands, forearms, etc. However, even though patients suffering from vibration disease today receive substantial benefits, there has been much controversy about the extent of responsibility that should be assumed by the employer. This controversy is illustrated by a recent court case in which the plaintiffs, patients with vibration disease, first won considerable compensation from their employer, only to have the case overturned in a higher court ruling. It is urged that acceptable international guidelines and criteria be established for the legal control, treatment, and prevention of the hand-arm vibration syndrome.