It is best to reconstruct two adjacent fingers in multiple finger amputations to achieve tripod pinch, stronger hook grip, wider span of grasping and lateral stability. From January 1984 to January 2003, simultaneous double second toe transfer was performed for reconstruction of adjacent fingers in 140 patients. Reconstruction was primary in 48 and secondary in 92 patients. Functional thumb was present in all of them. There were 104 male and 36 female patients with an average age of 29.1 (range: 2-57). Index-middle fingers were reconstructed in 90 patients, middle-ring fingers were reconstructed in 49 of them and ring-little fingers were reconstructed in one patient. The average operation time was 11 hours 25 minutes which was much shorter than double average time of a single second toe transfer (8 hours 31 minutes, double time: 17 hours 2 minutes). Reexploration rate of the transferred toes was 9.2 % and total survival rate was 98.9 %. Secondary surgery was performed in 98 patients to improve function and cosmesis, 42 patients were available for follow up at an average of 47.5 months (range: 2-210 months). Functional results were satisfactory in all patients and two-point discrimination was between 3 mm and 13 mm (average: 7.5 mm). No obvious donor site morbidity was noted except one severe hallux valgus deformity corrected by surgery. The functional and aesthetic results of double second toe transfers for adjacent two fingers reconstruction is superior to that of a single second toe to single finger reconstruction in multiple finger amputations. Double second toe transfer performed simultaneously reduces the cost and total time of the operation and enables faster rehabilitation and hastens patient adaptation.