In flexor tendon repair and reconstruction, patient expectations, failure rates, and debate intensity are high. While a consensus as to how to best address a given condition is yet to be reached, the authors have aimed to describe their choice of approach which they believe to be practical and effective. In our clinical experience, we have concluded that McLarney 4-strand cruciate core suture coupled with Silfversköld’s cross-stitch epitendineous suture is one of the optimal methods of tendon repair which can accommodate early active rehabilitation protocols, and chose to describe our method of executing it in elaborate detail. Due to several advantages it offers, we came to adopt Wide Awake Local Anesthesia No Tourniquet as the default anesthesia for hand surgeries. We prefer tendon transfers over two-staged tendon grafting, yet described both methods for reanimating digits with flexor tendon defects. We immobilize the hand in intrinsic plus position. We initiate rehabilitation at the third postoperative day by default. Preoperative assessment must be always done with due diligence, yet even when it is properly done, a condition may arise at any point during surgery that compels the surgeon to deviate from the initial plan and/or take extra measures including but not limited to skin resurfacing, pulley reconstruction or switching between tendon reconstruction methods. It is advised for the surgeon to be prepared for contingencies.