Introduction Congenital trigger thumb is secondary to a conflict between the flexor pollicis longus tendon and its inextensible tendon sheath. Though, the exact aetiology is still unknown, its treatment is usually surgical. Patients The authors present their experience of treating 52 consecutive patients with 63 trigger thumbs, with mean age 32 months, range (12 months to five years). Twenty-nine boys and 23 girls. Right thumb 37 and left thumb 26, 11 patients had have bilateral trigger thumb. Each was exclusively treated by percutaneous release of the A1 pulley using a needle. Results Fifty-two with 50 treated trigger thumbs were available for follow-up. The mean follow-up after this procedure was 28 months (range 12–30 months). Fouty-eight thumbs had a good result without any recurrence of triggering. Two thumbs had recurrent triggering and were subsequently successfully treated by open release. No thumbs demonstrated any neurovascular deficit clinically. Conclusion Percutaneous release of congenital trigger thumb can be performed safely and effectively in children by a surgeon specializing in hand surgery.