This chapter delves into the unique role of finite element analysis (FEA) in comprehensively understanding and addressing boutonniere deformity. This complex condition, characterized by hyperextension of the distal interphalangeal (DIP) joint and flexion at the proximal interphalangeal (PIP) joint, primarily results from injury to the extensor mechanism, particularly a central slip tear. Traditional cadaveric studies, while valuable, are limited in quantifying the intricate stresses and strains experienced by finger structures in vivo, thereby hampering a complete understanding of the deformity’s pathophysiology. FEA, however, emerges as a robust computational tool that enables the detailed simulation of the finger’s biomechanical environment under both normal and pathological conditions. In this context, FEA emerges as a robust computational tool that enables the detailed simulation of the finger’s biomechanical environment under both normal and pathological conditions. This chapter discusses recent advancements in the development of anatomically accurate digital models of the finger, which can replicate individual anatomical variations and simulate various injury scenarios. Emphasis is placed on the interplay between the central slip, lateral bands, and supporting structures, such as the triangular ligament and interosseous fibers, which are crucial in the progression of boutonniere deformity. This chapter underscores the potential of FEA to revolutionize therapeutic strategies in hand surgery. It highlights how FEA facilitates the visualization of stress redistribution across ligamentous structures and informs the optimization of conservative treatment options, such as therapeutic splinting. Additionally, it addresses the role of FEA in surgical planning by enabling virtual repair simulations that enhance the precision of surgical interventions. Ultimately, this chapter underscores the promise of finite element analysis in providing critical insights into the pathogenesis of boutonniere deformity and its potential to revolutionize therapeutic strategies in hand surgery.