Abstract: A handheld tattoo machine with a low vibration drive unit and an offset, removable driven grip tube. The drive unit includes a rotatable drive shaft; a cam attached to the distal end of the shaft, the cam having a cam face at an angle to the longitudinal axis of the drive shaft; and a drive housing enclosing the drive shaft and cam. The drive housing includes a driven grip tube receiving bore having a longitudinal axis parallel to and offset from the longitudinal axis of the drive housing to facilitate ease of use by the operator. The removable driven grip tube includes a reciprocal needle bar having a cam follower at a proximal end and a needle attachment surface at a distal end.