Microvascular replantation of digits distal to the proximal interphalangeal joint were reviewed in 24 digits in 18 patients. Of the 24 digits studied, five were seen in patients who had a single digit amputated and replanted, 10 were seen in patients who had multiple distal digital amputations and replantations, and eight were seen in patients who had other proximal digital replantations or other associated hand injuries in addition to the distal replantations. Survival rate in this study was 96%, and the mean active range of motion at the proximal interphalangeal joint was 95 degrees with 8.9 degrees active motion at the distal interphalangeal joint. Two-point discrimination averaged 11 mm, and all patients had some cold intolerance. The nine students in this study required a mean 1.7 months to return to school; nine patients were workers and required a mean of 5.1 months to return to work. Acceptance for the procedures was overwhelmingly good. Replantation of an amputated digit distal to the proximal interphalangeal joint in selected cases can be a worthwhile procedure.