Objective To report the method of improvement of reconstructed thumb or finger shape with second toe transplantation by local flap of thumb or finger stump. Methods From June 2006 to June 2016, 16 patients with third degree defect of thumb or finger were treated by emergency reconstruction with second toe transplantation. During the operation, the local flap of thumb or finger stump was embedded into the dorsal or lateral side of the middle part of the toe to increase the circumference of the reconstructed thumb or finger neck and improve the reconstructed thumb or finger shape. Results Postoperatively, all the reconstructed thumbs and fingers survived, as well as the local flaps. The narrowing neck of reconstructed thumb or finger was significantly improved. The postoperative follow-up time ranged from 5 to 14 months with an average of 11 months. The reconstructed thumb or finger achieved natural shape and good function. The sensory recovery of pulp was good and the patients were satisfied with the results. Conclusion Emergency reconstruction with the local flap of thumb or finger stump being embedded into the middle part of second toe can increase the circumference of the reconstructed thumb or finger neck, which may be an ideal method for improving the shape of the reconstructed thumb or finger. Key words: Thumb; Surgical flaps; Surgery, plastic; Reconstructionn