From 1988 to 1999 we operated on 22 patients for pre-axial polydactyly. We retrospectively reviewed all files and we clinically reviewed 16 patients. We report on the epidemiology, the surgical technique, the outcome and the complications. All patients were operated on by the same hand surgeon (L.D.S.) and reviewed by an independent observer (S.K.). Aesthetic and functional outcome is reported. In general the surgical treatment for pre-axial duplications gives excellent functional and good aesthetic results. According to the Egawa score, 13 patients obtained an excellent, one a fair and two a poor result. The overall satisfaction rate is very high for both patient and parents and the complication rate was low. The functional outcome seems to be related to the stability of the interphalangeal and metacarpo-phalangeal joints. The most frequent aesthetic problem is a deviation of the axis. Loss of mobility of the thumb seems to be of less importance.