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We introduce HOIGPT, a token-based generative method that unifies 3D hand-object interactions (HOI) perception and generation, offering the first comprehensive solution for captioning and generating high-quality 3D HOI sequences from a diverse range of conditional signals (\eg text, objects, partial sequences). At its core, HOIGPT utilizes a large language model to predict the bidrectional transformation between HOI sequences and natural language descriptions. Given text inputs, HOIGPT generates a sequence of hand and object meshes; given (partial) HOI sequences, HOIGPT generates text descriptions and completes the sequences. To facilitate HOI understanding with a large language model, this paper introduces two key innovations: (1) a novel physically grounded HOI tokenizer, the hand-object decomposed VQ-VAE, for discretizing HOI sequences, and (2) a motion-aware language model trained to process and generate both text and HOI tokens. Extensive experiments demonstrate that HOIGPT sets new state-of-the-art performance on both text generation (+2.01% R Precision) and HOI generation (-2.56 FID) across multiple tasks and benchmarks.