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This book examines the history of Black Hand crime in Chicago primarily from 1905 to 1920 and challenges the belief that the Black Hand was an extension of the Sicilian Mafia. A crude method of extorting money from primarily wealthy Italians, the Black Hand involved sending victims a letter stating that they would come to harm if the blackmailers' demands were not met; the threatening letter often included a drawing of a black hand or other frightening symbols.

While many criminologists and scholars believe that Black Hand crime originated in Italy, that only Southern Italians and Sicilians committed Black Hand crime, and that only Southern Italians and Sicilians were Black Hand victims, Robert M. Lombardo argues that Black Hand crime actually evolved as the result of social conditions within American society such as the isolation of the Italian community, political corruption, and an ineffective criminal justice system. He shows that this association of the Black Hand and the Sicilian Mafia is a media construction, resulting from a narrative created by the news media despite the fact that many non-Italians also committed Black Hand crimes. Looking at the Black Hand from a sociological perspective, the book discusses the "news-making criminology" that tied Black Hand crime to the Sicilian Mafia and Neapolitan Camorra and the evolution of traditional organized crime in Chicago and elsewhere.