The history, physiology and diagnosis of vibration syndrome in chipping and grinding workers were reviewed and discussed. Patients suffering from vibration syndrome may become occupationally disabled due to a decreased manual dexterity and an inability to work in cold temperatures. The disease was first identified in 1911 among Italian miners. The first study in the United States was conducted in 1918 and examined a population of limestone cutters and marble workers. Not much is known about the physiologic basis of vibration syndrome or the influence of specific attributes of vibration such as acceleration, frequency spectrum, or energy transferred to the hand. During the early stages of disease, the blanching episodes are likely caused by arterial vasospasm. In the absence of an actual attack, it is difficult to confirm the diagnosis of vibration syndrome. In the early stages of the disease the diagnosis is based largely on the description of the symptoms with intermittent tingling and/or numbness of the fingers in most cases being the first symptom experienced. As the disease continues, in some cases, the hands become constantly cyanotic and fingertip ulcerations occur.