The aim of the study was to describe a developmental trend of hand use for picking up and stacking blocks from the age of 18 months to 7 years. A second aim was to determine whether there is a relationship between right-hand use while building a tower and manual laterality at school age. A total of 28 children were asked to build a tower at five longitudinal assessments. The use of the right hand fluctuated considerably with age (p<.05), but no age-related increase was observed. Right-hand use was rather prominent at 18 months, decreased significantly at 26 months, increased at age 4;7, decreased again at 5;7, and finally increased again at age 7. From age 4;7 onwards, the percentage of right-hand use for stacking the blocks was significantly (p<.05) related to the laterality quotient at school age.