OBJECTIVE To compare the societal preferences for finger replantation between the United States (US) and Japan and to investigate factors influencing the preferences. METHODS A sample of the general population without current hand disease or condition was recruited via flyers posted in public areas of 2 major academic centers in the US and Japan. The recruited subjects completed a survey presenting finger amputation scenarios and various factors that may affect treatment decisions. We performed univariate analysis using treatment preference as the outcome and all other factors as possible predictors using the chi-square test. RESULTS Most respondents in both countries preferred replantation and there was no significant difference between the US and Japan. Treatment preference was significantly associated with the importance of appearance, recovery time, and the chance of survival of the replanted digit. There was no association between treatment preference and attitudes regarding body integrity or estimate of stigma toward finger amputees. Japanese participants agreed more with statements of body integrity, and Japanese respondents rated appearance, sensation, and chance of survival of the replant as more important than did American participants. CONCLUSIONS Patient preference is not driving the decrease in finger replantations in the US. The general public in both countries prefer replantation over wound closure for digit amputations. METHODS Economic and decision analysis III.