Background: 14% to 30% of all treated patients examined in emergency rooms have hand injuries. Tendon injuries rank 2nd (29%) of all patients treated for hand injuries. Objective: To demonstrate the functional outcomes of double-strand and four-strand procedures for the repair of hand flexor tendons and the benefits of early rehabilitation. Patients and methods: We carried out this prospective study on 40 patients who had completely cut flexor tendons of the hand at the plastic and burn surgery department of Al-Hussein & Bab Elsheria University Hospital, Al-Azhar University (Cairo). Results data suggest that, when it comes to hand flexor tendon restoration, there is no statistically significant difference between modified Kessler and 4 strand procedures. Also, no significant difference statistically between 2 groups of the early rehabilitation (active and passive). Except when the surgeon employs the 4-strand approach, utilizing an early active rehabilitation strategy is more crucial. Conclusion: There were no statistically significant differences in the two strands' or the four strands' groups in terms of total active range of motion. However, we found that cruciate (4-strand) suture techniques are simple to carry out and sufficiently strong for post-operative rehabilitation that begins early. Early active mobilization was associated with improved edema and soft tissue alterations. Compared to the inactive group, active motion significantly reduces adhesion development. Also, no variation was detected in the rupture rate between the two groups.