Hand mesh reconstruction from the monocular image is a challenging task due to its depth ambiguity and severe occlusion, there remains a non-unique mapping between the monocular image and hand mesh. To address this, we develop DiffHand, the first diffusion-based framework that approaches hand mesh reconstruction as a denoising diffusion process. Our one-stage pipeline utilizes noise to model the uncertainty distribution of the intermediate hand mesh in a forward process. We reformulate the denoising diffusion process to gradually refine noisy hand mesh and then select mesh with the highest probability of being correct based on the image itself, rather than relying on 2D joints extracted beforehand. To better model the connectivity of hand vertices, we design a novel network module called the cross-modality decoder. Extensive experiments on the popular benchmarks demonstrate that our method outperforms the state-of-the-art hand mesh reconstruction approaches by achieving 5.8mm PA-MPJPE on the Freihand test set, 4.98mm PA-MPJPE on the DexYCB test set.