Background <p>Digital replantation is a microsurgical procedure aimed at restoring amputated digits. Survival and functional recovery are influenced by ischemia time, injury mechanism, and repair technique. This study aims to systematically evaluate prognostic factors associated with survival and functional outcomes following digital replantation.</p> Methods <p>A systematic review was conducted using PubMed/MEDLINE, Scopus, SpringerLink, and Google Scholar through October 2025. Studies reporting follow-up outcomes after digital replantation were included.</p> Results <p>Twenty-five studies comprising 7,278 replanted digits met inclusion criteria. Survival ranged from 50% to 100%, with a median of 85%. Sharp injuries, shorter ischemia times, and dual venous anastomoses were consistently associated with improved survival. Functional outcomes demonstrated a median total active motion of 67.5°, two-point discrimination values typically ranging between 1.65 and 20&#xa0;mm, with a weighted mean of 5.6&#xa0;mm, and DASH scores ranging from 9.64 to 22.3. Sensory recovery assessed using Semmes–Weinstein monofilaments was variable. Risk of bias was predominantly moderate due to retrospective study design and limited adjustment for confounding factors.</p> Conclusions <p>Digital replantation achieves high survival and generally favorable functional outcomes. Combined assessment using objective functional measures and patient-reported outcomes is essential for comprehensive evaluation.</p> Level of Evidence <p>: Not gradable.</p>