[Objective] A comparative analysis of the clinical efficacy of venous reflux using palmar artery venousization and anastomosed dorsal vein in the replantation of distal segment amputated fingers. [Methods] A retrospective analysis of the clinical data of 68 patients with 79 fingers who sufferd replantation of amputated finger selected palmar artery venousization or anastomosed dorsal vein from January 2013 to April 2020 in our hospital. The clinical results of the dorsal vein surgery program were compared. Among them, 42 replanted fingers of the venous palmar artery were used as the test group, and 37 replanted fingers that matched the dorsal vein were the control group. The incidence of elephants, the incidence of complications, the survival rate of replantation, the long-term replantation finger shape score, and the sensory rating were statistically analyzed. [Results] Followed up for 6-18 months after operation, the incidence of vascular crisis (11.9% vs. 32.4%), the incidence of complications (14.2% vs. 35.1%), and the survival rate of replantation (88 % vs. 78%); the appearance score and sensory score of the test group were higher than those of the control group, and the difference between the groups was statistically significant (P <0.05). [Conclusion] The use of palmar arterioles venous replantation for replantation of anastomosed veins has a smoother venous blood return, less occurrence of vascular crisis, and a lower incidence of complications, which can improve replantation Finger survival rate, long-term postoperative replantation finger shape score, and higher sensory rating. It can be used as a preferred option in the replantation of the distal segment amputated finger.