The Oberg, Manske and Tonkin (OMT) Classification of Congenital Hand and Upper Limb Anomalies was adopted as the official IFSSH classification in 2014 with recommendations for 3-yearly reviews and updates. This report examined the evidence and feedback from the scientific community to see whether changes to the 2020 OMT should be made. The Committee concluded that no current changes are required, but highlighted a number of areas where further research and discussions are needed. These areas include the conditions of symbrachydactyly vs transverse arrest, the ongoing challenge with classifying syndactyly, and the nomenclature of arthrogrypotic conditions. The OMT Classification continues to enjoy high inter- and intra-rater reliability, thus establishing its central place as a robust classification system in various registries around the world.