Background: The main goal of flexor tendon surgery is to restore digital motion by providing tendon healing and preserving tendon gliding. The formation of peritendinous adhesions around the repair site is one of several adverse events that may prevent achievement of this goal Flexor tendon injuries occur frequently, adhesions between the tendon and its sheath are the most common complication after tendon repair. The using of venous graft as a tendon sheath substitute following tendon repair is a new technique for managing tendon injury that may improve the result of existing method [1, 2]. Methods: In this study twelve patients were seen within 6 months in Plastic Surgery Unit, Surgery Department, Zagazig University Hospital, and El-Ahrar Teaching Hospital in Zagazig. However, no patient escaped or was excluded from the study. Those 12 patients were selected among the cases of hand trauma coming to the hospital with Pure Flexor tendon injuries to assess our study without affecting other injures ( orthopedic, vascular and nerve injures). Results: All patients were assessed using the total active motion (TAM) scoring Final assessment after a follow-up period of 6 months revealed excellent range of movement in two cases, good range of movement in 10 cases and good result in 2 cases. Conclusion: the use of autologous vein graft as a replacement of tendon sheath has many advantages like; it is not expensive, being autologous so not carrying the risk of infection, also it will not affect the tendon healing like other materials. It also improves tendon nourishment.