Background:Surgery for trigger finger is done to increase the space for flexor tendon allowing the finger to bend and flex smoothly. The site and shape of the incision with regard to hand function and anatomic considerations are important for the success of the surgery.The aim of this prospective study was to compare longitudinal versus transverse incisions in trigger finger release as regard functional outcome, patients satisfaction and surgeon preference. Methods: Forty patients (44 trigger fingers) underwent surgical release; 22 fingers with longitudinal incision and 22 with transverse incision. There were 16 male and 24 female patients, with the mean age 31±5.5 years. DASH score was used to assess the functional outcome. All the patients were followed up to a period3 to 10 months with a mean 6±0.7 months. Results: The mean DASH score improved significantly in both groups with no statistically significant difference between the two groups. Although the surgical release using longitudinal incision was shorter in duration than that of transverse incision, there was no statistically significant difference in the operative time (p=0.65). Surgeon preference was better with longitudinal incision. Conclusion: Although there was no statistically significant difference between the outcome of the patients with transverse versus longitudinal incisions regarding the operative time, functional improvement, and patient satisfaction, there was more surgeon preference with the longitudinal incision