This article presents the excision of a ganglion cyst from the distal phalanx of the middle finger, performed under local anesthesia. The video demonstrates vertical incision over the cyst, careful subdermal dissection to expose the cyst wall and pedicle, and complete removal without injury to surrounding structures. Special attention is given to protecting the nail matrix and achieving hemostasis. Closure is completed with absorbable sutures, followed by a brief period of limited finger motion to support healing.