86 patients (61 completed follow up) with trigger finger(s) were randomized to receive surgical release of the A1 pulley with a transverse or longitudinal surgical site incision. The primary outcome of interest was scar quality, as measured by the Patient and Observer Scar Assessment Scales (PSAS; OSAS). Secondary outcomes of interest included the Disability of the Arm, Shoulder and Hand (DASH) score and the rate of complications. Follow up was performed at 2, 8 and 54 weeks post-operation. No significant differences were observed between the transverse and longitudinal incision groups in all outcomes, at all time-points.