tā de shǒu shàng yǒu xuè.

的 is the common particle used to show possession or description.

So:

• 他 = he / him
• 他的 = his
• 他的手 = his hand / his hands

In this sentence, 他的手上 means on his hand or on his hands.

上 literally means on, above, or on the surface of.

So:

• 手上 = on the hand / on one’s hand(s)

Chinese often uses a noun + location word like this:

• 桌子上 = on the table
• 墙上 = on the wall
• 手上 = on the hand

So 他的手上有血 is literally something like On his hand, there is blood.

有 means to have, but it is also very often used to mean there is / there are in a certain place.

Here it works like an existence pattern:

• 地方 + 有 + 东西
• in/at some place + there is + something

So:

• 他的手上有血
• literally: On his hand, there is blood

This is why 有 appears instead of a verb meaning to be located.

That sentence is also possible, but the focus is a little different.

• 他的手上有血 = There is blood on his hand.
  
  • This sounds like introducing the presence of blood.
• 血在他的手上 = The blood is on his hand.
  
  • This sounds more like you are identifying the location of the blood.

So the original sentence is the more natural choice when you want to say that blood is present there.

Yes, sometimes.

You may hear:

• 他手上有血

This is common in spoken Chinese, especially when the relationship is obvious, such as with body parts or close personal relationships.

Compare:

• 他的手上有血 = slightly fuller, more standard
• 他手上有血 = very natural in speech

Both are correct.

It can mean either hand or hands.

Chinese nouns usually do not change form for singular and plural the way English nouns do. Context tells you which meaning is intended.

So 他的手上有血 could mean:

• there is blood on his hand
• there is blood on his hands

If you want to be more specific, you can say:

• 他的一只手上有血 = there is blood on one of his hands
• 他的两只手上都有血 = there is blood on both his hands

In standard Mandarin, it is usually pronounced xuè here.

So the sentence is:

• 他的手上有血
• tā de shǒu shàng yǒu xuè

A few notes:

• x in pinyin is not like English x
• xuè sounds roughly like shyueh, but not exactly
• the tone is 4th tone, so it falls sharply

You may also hear a colloquial pronunciation xiě in some contexts or regions, but xuè is the standard pronunciation to learn first.

They are not the same.

• 手上 = on the hand / on one’s hands
• 手里 = in the hand / in one’s hand / being held

So:

• 他的手上有血 = there is blood on his hand
• 他的手里有刀 = there is a knife in his hand / he is holding a knife

If the blood is on the surface of the hand, 手上 is the natural choice.

Not necessarily.

他的手上有血 only tells you that there is blood on his hand. It does not automatically mean the blood came from his hand.

It could mean:

• his hand is injured and bleeding
• he touched someone else’s blood
• he got blood on his hand some other way

If you specifically want to say his hand is bleeding, you would usually say something more direct, such as:

• 他的手流血了 = his hand is bleeding / his hand started bleeding

Chinese often puts the location before 有 when saying that something exists somewhere.

The pattern is:

• [location] + 有 + [thing]

So here:

• 他的手上 = on his hand
• 有 = there is
• 血 = blood

That gives:

• 他的手上有血
• literally: On his hand there is blood

This word order is very common and natural in Chinese.

In writing, 他 usually means he or him.

But in spoken Mandarin, 他, 她, and 它 are all pronounced tā. So if you only hear the sentence, you cannot tell from pronunciation alone whether it is:

• 他 = he
• 她 = she
• 它 = it

The written character tells you which one is meant.

Yes, it is natural.

Other common versions include:

• 他手上有血。 = There is blood on his hand.
• 他的手上都是血。 = His hands are covered in blood.
• 他手上沾了血。 = He has blood stuck/on his hand.
• 他的手流血了。 = His hand is bleeding.

The original sentence is a straightforward, neutral way to say that blood is on his hand.