We undertook a historical cohort study of 93 cases of ring avulsion injuries in order to analyze prognostic factors that can affect the outcome. The patients ages ranged between 12 and 66 years old (average 34); eighty percent of the patients were male and only one case did not affect the ring finger. We found that 67% of patients were in modified Urbaniak class III and class IV. Eight patients (10.4%) had primary amputations and in 14 patients(18.2%), there was failure of revascularization leaving 55 patients (71.4%) with successful revascularization. The survival rate was 86.7% in Urbaniak group II; 78.6% in group III and 76.9% in group IV. Our study leads us to the following conclusions: There was no correlation between age and the final outcome (X2 p=0.33) There was no difference between classes II, III and IV regarding the rate of survival. Lesions of the flexor digitorum profundus affected the TAM. This was statistically significant (t-Test p=0.043) Repairing both arteries was better than repairing one artery (X2 p=0.02) The best chance of success in revascularization was by end to end apposition of arteries or veins (either in less severe cases or with bone shortening). When vein grafts are necessary, it is better to do more than one vein graft (X2 p=0.02) Pain was an uncommon symptom after a ring avulsion injury (X2 p=0.62) Pain was more common in patients in whom the finger was finally amputated as compared to the successful revascularization (X2 p=0.03) There was no difference in the TAM among different classes of injury (t-Test p=0.635; p=0.45; p=0.12). This can be explained by advances in the management of these injuries. Ring avulsion injuries present challenges to the hand surgeon. However, with modern techniques in microsurgery, there is a high survival rate along with good return of function. Pain is not associated with a successgfully revascularized finger as compared to the amputated digit. We feel that every effort should be made to preserve the digit in this type of injury.