Objective To study the therapeutic effect of microsurgical without shortening phalanx of replantation of distal amputated finger. Methods From June 2018 to June 2020, 62 patients with last segment severed finger in our hospital were selected as the research objects. They were divided into observation group and control group by random number table method, with 31 cases in each group. The control group was treated with traditional finger amputation surgery, and the observation group was treated with microsurgical without shortening phalanx of replantation of distal amputated finger. The surgical effect, replantation survival, pain degree, quality of life, function of severed finger joint and complications were compared between the two groups. Results The excellent and good rate of operation in the observation group was 96.77%, which was higher than 77.42% in the control group (P <0.05). The survival rate of replantation in the observation group was 87.10%, which was higher than 58.06% in the control group (P <0.05). The pain score of the observation group was lower than that of the control group, and the quality of life score was higher than that of the control group (P <0.05). After treatment, the function score of severed finger joint in the observation group was higher than that in the control group (P <0.05). The incidence of complications in the observation group was 9.68%, which was lower than 32.26% in the control group (P <0.05). Conclusion The curative effect of microsurgical without shortening phalanx of replantation of distal amputated finger is definite, and the survival rate of replantation is high. Meanwhile, it can effectively improve the patient's finger joint function, reduce pain, help to improve the quality of life, and has fewer postoperative complications and higher safety. It is worthy of clinical application.