Flexor tendon injuries in the hand present a real challenge in treatment. Poorly chosen or poorly executed treatment may lead to a functionless finger at best, impairing total hand function. A variety of approaches to treatment of flexor tendon injuries is available to the specially trained surgeon and a particular method is selected based on the merits of the case in question. Primary tendon repair is a viable choice under the proper conditions, while delayed primary repair allows a somewhat broader application of this technique. Flexor tendon grafting remains a very useful operation for the surgeon caring for tendon injuries of the hand.