The title Shadow Hand was bestowed upon the second-in-command serving a Sith monarch, also known as a Sith'ari.

Subsequently, members belonging to the Sith Order adopted it both as a designation for the second-in-command under a Sith Master and as a term synonymous with an apprentice.

The Shadow Hand of King Adas inherited the fallen king's holocron. Conversely, another Shadow Hand serving King Hakagram Graush, many millennia later, betrayed their master to the newly arriving Dark Jedi, thereby setting the stage for the emergence of the first Dark Lords of the Sith. Following Hakagram Graush's demise, Pall designated his fellow Dark Jedi as his new Shadow Hands.

During the Krath Holy Crusade, the spirit of the long-deceased Dark Lord of the Sith Marka Ragnos imprinted Ulic Qel-Droma with the mark of a Shadow Hand, foretelling that he would become Exar Kun's foremost apprentice. During the Jedi Civil War, after eliminating his master, Darth Malak appointed Darth Bandon as both his apprentice and Shadow Hand. Some years later, during the Dark Wars, Visas Marr functioned as Darth Nihilus's Shadow Hand, having been rescued from the devastated surface of her homeworld, Katarr. This practice persisted among later Sith. Darth Vader trained his own disciples, including Lumiya and Flint, with the intention of orchestrating a contest among them to identify a champion worthy of becoming the Dark Lord's Shadow Hand. Before Vader, Darth Cognus, herself a Sith in the lineage of Darth Bane like Vader, instructed her apprentice Darth Millennial to serve as a Shadow Hand.

Under Darth Bane's Rule of Two, the Dark Lord of the Sith was embodied by the Sith master, while the apprentice fulfilled the role of Shadow Hand until they assassinated their master to ascend as the new Dark Lord, subsequently choosing their own apprentice to be their Shadow Hand.

The resurrected Darth Sidious employed the designation for his campaign to retake the galaxy.