Objective: To investigate the application of digital artery transposition in replanting severed fingers with vascular defects and its impact on nerve and joint function recovery. Methods: 200 patients who received replantation of severed fingers were randomly divided into artery transposition group (n = 100) and vein transplantation group (n = 100). The digital artery transposition technique was used in the artery transposition group, and the autologous vein bridging technique was used in the vein transplantation group. The clinical efficacy and survival rate of severed fingers were compared between the two groups. Results: The clinical excellent and good rate in artery transposition group was significantly higher than that in vein transplantation group (P < 0.05). Conclusion: The transposition of digital artery is effective and safe in replantation of severed fingers with vascular defects.