To explore the effect of replantation of severed finger under microscope in the treatment of patients with severed finger. Methods 42 patients with amputated fingers were included in the study (January 2021 to August 2023). They were divided into two groups according to different surgical methods, namely observation group (under microscope amputated finger replantation surgery) and control group (conventional amputated finger replantation surgery), each with 21 cases, and the therapeutic effect was compared. Results The total effective rate of treatment in the observation group was higher than that in the control group (P <0.05). Compared with the control group, the observation group had greater DIPJ, longer severed finger nail length, shorter twopoint discrimination sense, and lower complication rate (P <0.05). The score of severed finger function in the observation group was higher than that in the control group, with statistical significance (P <0.05). Conclusion The effect of replantation operation under microscope for patients with severed finger is ideal.