Pediatric trigger thumb presents most commonly in a locked flexed position at an age of around 2 years, whereas pediatric trigger finger more commonly presents as a triggering phenomenon in a slightly older population. Pediatric trigger thumb is 10 times more common than pediatric trigger finger. Pediatric trigger thumb and fingers should not be managed like their adult counterparts. In the pediatric population, the locked trigger thumb can be observed for 3–6 months to determine if resolution may occur; if it does not, surgical release is indicated. Surgical release of the trigger thumb includes release of the A1 pulley, while surgical release of the trigger digit includes release of the A1 and A3 pulleys with possible resection of one slip of the flexor digitorum superficialis tendon. Surgical results are excellent with few complications.