Objective To investigate the effect of free superffcial palmar branch of radial artery ffap on incision aesthetics in patients with ffnger soft tissue defect. Methods A total of 60 patients with ffnger soft tissue defect admitted to our hospital from February 2023 to April 2025 were selected. According to the random number table method, they were divided into the control group and the observation group, with 30 patients in each group. The control group was treated with free venous ffap, and the observation group was treated with free superffcial palmar branch of radial artery ffap. The hand function scores, incision aesthetics, rehabilitation status and sensory recovery of fingers were compared between the two groups. Results After operation, the hand function scores in the observation group were all higher than those in the control group (P<0.05). At 30 days after operation, the scores of incision aesthetics in the observation group were all lower than those in the control group (P<0.05). The rehabilitation status in the observation group was better than that in the control group (P<0.05). The sensory recovery grade of ffngers in the observation group was better than that in the control group (P<0.05). Conclusion In patients with ffnger soft tissue defect, free superffcial palmar branch of radial artery ffap can promote the recovery of hand function and ffnger sensory function, improve incision aesthetics and effectively optimize rehabilitation status.