Stenosing flexor tenosynovitis of the digital flexor tendon sheath, also known as trigger finger, occurs when there is a size mismatch between the flexor tendon and the surrounding retinacular pulley system at the first annular (A1) pulley. The A1 pulley overlies the metacarpophalangeal (MCP) joint at the base of the finger. When the flexor tendon thickens or becomes inflamed, its ability to properly glide through the flexor tendon sheath becomes impaired. Thus, the tendon catches as the finger is flexed and extended. Trigger finger is a frequently encountered condition for most hand surgeons, and it often coexists with other disorders such as diabetes, rheumatoid arthritis, amyloidosis, and carpal tunnel syndrome.^1–3 The cause is often idiopathic, though it has been speculated to result from overuse or repetitive movements of the finger.^1,4 Conservative management includes activity modification, splinting, short-term nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroid injection, and other adjuvant therapies. This video demonstrates a surgical approach to the treatment of trigger finger via the open A1 pulley release procedure.