I'm not hitting anything with hand to hand? Skill is currently 31.

Edit: it might be Morrowind Rebirth 3.9 problem as there's: An experimental fix for hand-to-hand dealing too much damage.

Maybe but even at skill level 31 you are going to miss quite a bit in vanilla.

True. get it to ~50, then you shalln't miss.

Yeah but currently I can't get single hit in like 500 tries.

Because hand-to-hand is useless. Unless you want to spent an absurd amount of hours upon hours leveling it up the hard way, you should just go find a trainer for it. And even then if you have a competent level in hand-to-hand it basically does nothing. My character is around level 60 in it, and it still doesn't do much damage. I only trained it because you need a good level in it for one quest in Raven Rock. There really isn't much of a point to it otherwise. Even against some unarmored NPCs like berserkers on Solstheim you won't do much damage even when you land a hit.

That's because it drains fatigue before health.

I disagree, as I believe that it isn't useless. There is seldom anything more fun than knocking out someone then beating them to death!

You also need it in Helnim fighters guild guest, which is how I found it doesn't work for me. I've never used it as a skill, but h2h opponents can be brutal at times.

Just set my hand to hand to 100 and I can actually hit something. So it's just one of these skills like security that you need to be over some threshold.