Background. A study was designed to compare the efficacy of anesthesia between transthecal digit block (TDB) and single injection volar subcutaneous block. Methods. A 36-patient, randomized, controlled, prospective investigation was undertaken. The parameters included the onset of time to achieve anesthesia, visual analog scale pain score during the infiltration, and anesthesia duration. Results. The mean time of the onset of anesthesia was 120 +/- 8.9 seconds for transthecal blocks compared with 140 +/- 7.8 seconds for the single injection volar subcutaneous digit blocks, and the mean time to loss of anesthesia was 3 +/- 0.12 hours versus 4.3 +/- 0.21 hours, respectively. The pain score was 3.1 +/- 0.12 versus 2.4 +/- 0.17. The difference among the three parameters between the two groups was statistically significant (P < 0.05). Conclusion. These results confirm the efficacy of the transthecal block and the single injection volar subcutaneous digit block for achieving anesthesia of the finger, but the author prefers single injection volar digit block since it causes less pain during injection and the anesthesia lasts longer.