Stenosing flexor tenosynovitis, or trigger finger, has been treated with open, endoscopic, and percutaneous tendon sheath incisions. A comparison of techniques highlights increased cost, procedure time, and postoperative recovery associated with open surgical treatment. We conducted a study of the efficacy of percutaneous tendon sheath incision as a treatment for trigger digit. Using percutaneous tendon sheath incisions, a single surgeon treated 596 trigger digits (429 patients) over a 10-year period. Successful release was defined as symptom relief on follow-up, or patient request for no further treatment. There were 537 successful releases (90.1%). Of the 59 failures, 17 underwent another percutaneous procedure (15 successful) and 40 underwent open surgical release (100% successful); 2 patients requested no further treatment. There were no significant differences in digit success rates and no complications. The success rate of this method was comparable to rates reported for open surgical procedures, but there were no instances of infection, chronic pain, or tendon or neurovascular damage. Percutaneous release is a safe, effective, and economical treatment option for trigger digits.