Trigger finger (also known as “stenosing tenosynovitis") refers to a mechanical impingement of the flexor tendon of the hand. The aim of this paper was to compare the outcome between 15 cases undergoing open surgical release and 15 cases undergo percutaneous needle release of trigger finger. A Prospective randomized study that included 30 adult patients diagnosed by clinical assessment and will be managed by open or percutaneous release of A1 pulley of the diseased finger. There was no statistically significant difference found between the two groups regarding triggering, nerve affection, satisfaction and stiffness, and there was a highly statistically significant difference found between the two groups regarding scar. The same results were obtained after 2 weeks, 3 months and 6 months. According to this study, trigger finger can be successfully managed by either open or percutaneous release, especially in terms of pain, function, return to work and patient satisfaction. However, percutaneous release offers advantages of shorter duration and less severity of postoperative pain, quicker return to work and better cosmesis. Nevertheless, these advantages might be overshadowed by significantly higher rates of residual finger triggering and of recurrence of finger triggering following percutaneous release compared with its open counterpart.