The biodynamics of human hand-arm system is one of the most important foundations for the measurement, evaluation, and risk assessment of hand-transmitted vibration (HTV) exposure. This paper presents a new conceptual model relating factors influencing cause-effect relationships for HTV exposure, a new study strategy, and a comprehensive review of the recent advances in the biodynamics closely associated with HTV exposure. The review covers the following five aspects: theoretical modeling of biodynamic responses, vibration transmissibility, driving-point biodynamic responses, evaluation of anti-vibration gloves, and applied forces. This review finds that some significant advances in each of these aspects have been achieved in the recent years. Several important issues and problems in the biodynamic measurement have been identified and resolved, which has significantly helped improve the reliability and accuracy of the experimental data. The results reported in recent years suggest that, from the point of view of biodynamics, the frequency weighting specified in ISO 5349-1 (2001) overestimates the low frequency effect but underestimates the high frequency effect on the fingers and hand. The major problems, issues, and topics for further studies are also outlined in this paper. It is anticipated that the further studies of the biodynamics of the system will eventually lead to establishment of a robust vibration exposure theory. Although this review focuses on the biodynamics of the hand-arm system, the fundamental concepts and some methodologies reviewed in this paper may also be applicable for the study of whole-body vibration exposure.