Objective: To compare the results of early active mobilization versus immobilization in term of rehabilitation after extensor tendon injury in zones IV–VIII. Study Design: Randomized control trial (Clinical Trial no. NCT04221113). Place and Duration of Study: Department of Plastic and Reconstructive Surgery, Dr. Ruth K.M. Pfau Civil Hospital, Karachi Pakistan, from Feb to Jul 2020. Methodology: Patients with extensor tendon injuries of zone IV–VIII were randomly allocated to Treatment Group (early Active Mobilization) and Comparison Group (Immobilization Group) and their total active motion score was observed at fourth, sixth and eighth week. Results: Overall mean age of study participants was 29.48±5.51 years. Half of the patients had single finger injury 25(50%). Most of the study participants presented with injury in zone V 32(64%). The two groups did not differ on basis of age (p=0.879), gender (p=1.00), zone involved (p=0.183) and finger involved (p=0.396). TAM score between the two groups was not significantly different at fourth week (p=0.384), sixth week (p=0.606) and eighth week (p=0.122). The frequency of complications between two groups was not statistically significantly different (p=0.667).Conclusion: The current study was unable to find the significant difference in patients’ outcomes when treated with early active mobilization and immobilization protocol.