The combined congenital malformation of partial or complete absence of the pectoralis major muscle and webbing of the fingers, on the same side, was first described by Poland in 1841. Ten percent of patients with syndactylism have the combined anomaly. The breast and nipple may be hypoplastic or absent. Lung herniation has been described in patients with absent or rudimentary development of ribs. Embryology, clinical features, and experience with three cases of this syndrome are presented. Surgery aims at creating the best possible functioning hand. Chest wall deformity usually does not require surgery, except in cases of lung herniation. Appearance may be improved by cosmetic chest surgery in specific instances.