The rule for management of flexor tendon injury is primary repair. Under unfavorable conditions, two stage reconstruction becomes an option. Several techniques had been practiced for flexor tendon reconstruction. The aim of this study was to make a comparative study of the outcome between the modified Paneva-Holevich technique and the flexor digitorum superficialis (FDS) tendon transfer in repair of neglected flexor tendon injuries. Methods: 40 patients were operated for flexor tendon reconstruction. They were divided into two groups (each 20 patients): The modified Paneva-Holevich technique (group I) and the FDS tendon transfer (group II). The results were assessed according to Active Range of Motion (AROM), patient satisfaction and complications. Results: Mean age was 32.3±10.51 years in group I and for group II was 34.40±9.99 years with no statistically significant difference. The majority of patients were male with right hand dominance of both groups. In group I: the most operated finger was the middle finger (50% of cases), while in group II was the ring finger (30% of cases). There were no statistically significant differences between both groups as regard AROM, patient satisfaction and complications. Conclusion: The modified Paneva-Holevich technique and the FDS tendon transfer are versatile and efficient for repair of neglected flexor tendon injuries with no superiority of one technique over the other.