Fracture of the pisiform is a rare condition with only few cases reported. According to the previous reports, the mechanisms of injury mostly are high-energy direct impact, such as a fall on the outstretched hand or use of the hand as a hammer against on object. This report describes the case of a 30-year-old baker complained of chronic pain over base of hypothenar area without any history of direct blow or sports injuries. After carefully X-ray evaluation, a transverse type displaced pisiform fracture was diagnosed. Occupational origin fatigue fracture might be the reason to explain the delayed diagnosed fracture instead of direct trauma.