First published in the March 1916 issue of Masses, a Chicago literary magazine featuring avant-garde writing, Sherwood Anderson's "Hands" became the first story in his first and most important collection Winesburg, Ohio. Although he had published two novels already, Anderson had difficulty finding a publisher for his collection. The editor who had published his novels thought the stories were too dark to attract readers. In fact, Winesburg, Ohio sold well and was widely reviewed. Most critics admired the book for its insight and honesty, but others labeled it crude and disgusting.

The stories all featured "grotesques," or psychologically isolated people who live in the small post-Civil War town of Winesburg. The central character of "Hands" is Wing Biddlebaum, a man who was a schoolteacher in another town until his attentions to his students were misunderstood as being erotic. Now he lives alone in Winesburg, afraid to get close to people for fear his hands will betray him again. The suggestion of sexuality, and particularly of homosexuality, was unusual in 1919, and readers and critics reacted strongly. Nearly all contemporary reviewers compared the book to The Spoon River Anthology, Edgar Lee Masters' 1915 collection of poems about different figures in a small town. Some said that the two authors depicted similar characters and debated over whose approach to the characters was gloomier.

Anderson often said that he created "Hands" in one sitting in 1915 and never changed a single word. Now that scholars have access to Anderson's handwritten manuscripts, it is clear that this legend is untrue, that the story reached its final form through a combination of inspiration and careful revision.