Ganglia are the most common soft tissue tumors of the hand. Ganglia found on the dorsum of the wrist usually arise from the scapholunate ligament and are usually located between the extensor digitorum communis tendon of the index finger and extensor pollicis longus tendon. Intratendinous ganglion is a very rare lesion of unknown etiology and natural history that originates within the tendon. A patient is described who presented with a painful mass on the dorsolateral aspect of the wrist due to an intratendinous ganglion of the extensor pollicis longus tendon. Treatment consisted of excision of the extensor pollicis longus tendon with ganglion followed by mini free tendon graft using palmaris longus tendon.