Ewing sarcoma is a malignant, small, round, blue cell tumor that often affects the long bones and pelvis. It is rarely seen in the bones of the hand. A minority of Ewing sarcoma cases arise in soft tissue. This case report details the clinical and radiological presentation of an extraosseous Ewing sarcoma of the index finger in a 22-year-old woman. Treatment consisted of an index ray amputation followed by adjuvant chemotherapy. After 1 year, the left hand had excellent function with an acceptable cosmetic appearance and no evidence of metastasis or local recurrence.