Digital avulsion injuries require urgent surgical intervention to prevent tissue necrosis and salvage the amputated digit. Successful digital replantation is predicated on (1) appropriate patient selection, (2) organized and efficient surgical repair of affected structures, and (3) close postoperative monitoring. The amputated part should be cleaned and placed in a moist saline gauze and placed in a plastic bag on ice. In the operating room, repair typically proceeds with back table identification of structures, followed by methodical repair of structures from deep to superficial: bone > tendon > arteries/veins > nerves > skin. Postoperative management involves monitoring of the revascularized digit, use of anticoagulation to prevent thrombotic complications, and a slow transition to a formal rehabilitation program with an occupational therapist. Following these principles, successful replantation rates have been shown to range from 66% to 90% and can provide a meaningful preservation of hand function for many patients (Sears and Chung, J Hand Surg Am 36A:686–694, 2011; Dzwierzynski, Replantation and revascularization. In: Nelligan P (ed) Plastic surgery, 3rd edn. Elsevier, London, pp 228–249, 2013).